Introduction The placement of intramammary marker clips has proven to be helpful for
tumor localization in patients undergoing
neoadjuvant chemotherapy and
breast-conserving surgery. The purpose of our study was to investigate the feasibility of using a
clip marker system for
breast cancer localization and its influence on the imaging assessment of treatment responses after
neoadjuvant chemotherapy. Patients and Methods Between March and June 2015, a total of 25 patients (n = 25), with a suspicion of invasive
breast cancer with diameters of at least 2 cm (cT2), underwent preoperative sonographically guided core needle biopsy using a single-use breast biopsy system (HistoCore™) and intramammary
clip marking using a directly adapted
clip system based on the established O-Twist Marker™, before their scheduled preoperative
neoadjuvant chemotherapy. Localization of the intramammary marker
clip was controlled by sonography and digital breast tomosynthesis. Results Sonography detected no dislocation of intrammammary marker clips in 20 of 25 patients (80 %), while digital breast tomosynthesis showed accurate placement without dislocation in 24 patients (96 %) (p < 0.05). There was no evidence of significant
clip migration during preoperative follow-up imaging after
neoadjuvant chemotherapy. No complication related to the
clip marking was noted and there was no difficulty in evaluating the treatment response to
neoadjuvant chemotherapy. Among the
breast-conserving surgeries performed, no cases were identified in which intraoperative loss of the marker
clip had occurred. Conclusion Our study underscores the importance of intramammary marking
clip systems before
neoadjuvant chemotherapy. Placement of marker clips is advised to facilitate accurate
tumor bed localization. With regard to digital breast tomosynthesis, its development continues to improve the quality of diagnostics and the
therapy of
breast cancer particularly for small
breast cancer tumors or in
neoadjuvant chemotherapy setting.