Imaging-Guided Localization (IGL)
occult lesion
DISEASE, PATHOLOGY
Before surgery, the most suspicious axillary node on imaging or palpation was biopsied via core needle biopsy or aspirated with a fine needle according to study-site specific standards and clipped. The clipping was performed at diagnosis or after receiving the pathology report confirming nodal disease. Images of the biopsy and clip placement were documented, e.g., by ultrasound (US). The IGL of the clipped and sampled node was optional, and performance was at the discretion of the surgeon. IGL of radiologically suspicious nodes, in addition to the clipped node, was neither mandatory nor prohibited. Any imaging technology was allowed for IGL, including US, computed tomography (CT), and magnetic resonance imaging (MRI). Any method was allowed for localization of the clipped node, such as the use of wire, iodine-125 or magnetic seeds, radioguided occult lesion localization (ROLL), or a tattoo. Specimen radiography was performed on all removed lymph nodes as measure of surgical quality assurance. If the clip was not documented in the specimen radiography, the patient was not randomized in the TAXIS trial and accordingly, was not included in this study.