For this reason, we studied the use of surgical clips for tumor localization in breast cancer patients who were scheduled for surgery after preoperative NAC. Surgical clips are considered safer than commercial breast markers because they are removed after surgery. Titanium clips are relatively less expensive than commercial breast markers, and both are composed mainly of titanium. ![]() Titanium surgical clips are readily available and have been proven to be safe in patients. The placement of radiopaque markers are essential for patients with NAC and BCS because a dramatic pCR in a patient with a nonradiopaque marker would not allow the surgeon to accurately locate and excise any residual cancerous tissue, or reconstruct the breast with a satisfactory cosmetic result. For these reasons, international breast cancer specialist panels in 20 referred to the importance of the radiopaque clip. Sometimes a dramatic pathologic complete response (pCR) can be achieved, but results vary with the treatment regimen (6.0%-32.9%). As new chemotherapeutic agents have been developed, patients who have undergone NAC have shown a positive response (approximately 80%). Until recently, none of these markers had been legally allowed for use in South Korea due to the lack of approval from the Korean Food and Drug Administration (KFDA), although clinicians have long advocated for a reliable, safe, and less expensive radiopaque marker. Many types of commercial breast markers have been developed and are widely used prior to NAC, especially in the United States. ![]() The placement of radiopaque markers has proven to be helpful and safe for tumor localization in patients undergoing NAC and BCS. ![]() The benefits of NAC performed prior to surgery are as follows: (1) reduction of mortality (2) improvement of surgical options, such as conversion to breast-conserving surgery (BCS) in operable patients, as well as surgery in previously inoperable patients and (3) early collection of information on the treatment response and tumor biology of the breast cancer. Neoadjuvant chemotherapy (NAC) has been the accepted standard of care for patients with operable or inoperable breast cancers.
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