{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T17:43:31Z","timestamp":1761155011358},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[1994,9,1]],"date-time":"1994-09-01T00:00:00Z","timestamp":778377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1994,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The role of radiotherapy in the management of the axilla in early breast cancer is examined. A few, carefully selected, clinically node-negative postmenopausal women may require no intervention to the axilla. Otherwise, surgical clearance is the preferred sole management of the axilla, resulting in an excellent level of local control and providing optimal information for the use of systemic adjuvant therapy. Axillary radiotherapy can also provide equivalent levels of long-term control in the clinically node-negative axilla, but the chronic disabling syndrome of brachial plexopathy is documented at all radiation doses that can sterilize microscopic disease, irrespective of the radiotherapy technique. A combination of radiotherapy and axillary surgery results in an increased morbidity rate compared with either alone. Women who receive radiotherapy to the breast alone are not at risk of brachial plexopathy.<\/jats:p>","DOI":"10.1002\/bjs.1800810906","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T20:54:15Z","timestamp":1172955255000},"page":"1277-1281","source":"Crossref","is-referenced-by-count":20,"title":["Radiotherapy and the management of the axilla in early breast cancer"],"prefix":"10.1093","volume":"81","author":[{"given":"S J","family":"Falk","sequence":"first","affiliation":[{"name":"Bristol Oncology Centre , Horfield Road, Bristol BS2 8ED,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1994,9,1]]},"reference":[{"key":"2024092815363476400_bib1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/0140-6736(91)92172-X","article-title":"The axilla: not a no-go zone","volume":"337","author":"Fentiman","year":"1991","journal-title":"Lancet"},{"key":"2024092815363476400_bib2","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1136\/bmj.308.6922.188","article-title":"Enraged about radiotherapy","volume":"308","author":"Sikora","year":"1994","journal-title":"BMJ"},{"key":"2024092815363476400_bib3","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1136\/bmj.308.6922.168","article-title":"Management of breast cancer in southeast England","volume":"308","author":"Chouillet","year":"1994","journal-title":"BMJ"},{"key":"2024092815363476400_bib4","first-page":"1035","article-title":"Management of early cancer of the breast. Report on an international multicentre trial supported by the Cancer Research Campaign","volume":"i","author":"Cancer Research Campaign","year":"1976","journal-title":"BMJ"},{"key":"2024092815363476400_bib5","doi-asserted-by":"crossref","first-page":"2827","DOI":"10.1002\/1097-0142(197706)39:6<2827::AID-CNCR2820390671>3.0.CO;2-I","article-title":"Comparison of radical mastectomy with alternative treatments for primary breast cancer. A first report of results from a prospective randomised clinical trial","volume":"39","author":"Fisher","year":"1977","journal-title":"Cancer"},{"key":"2024092815363476400_bib6","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/0960-9776(92)90011-P","article-title":"The role of axillary dissection in operable breast cancer","volume":"1","author":"Sacks","year":"1992","journal-title":"Breast"},{"key":"2024092815363476400_bib7","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/0167-8140(92)90013-K","article-title":"Selective avoidance of lymphatic radiotherapy in the conservative management of early breast cancer","volume":"25","author":"Hoskin","year":"1992","journal-title":"Radiother Oncol"},{"key":"2024092815363476400_bib8","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1001\/archsurg.1987.01400230030004","article-title":"The significance of local control in the primary treatment of breast cancer","volume":"122","author":"Hayward","year":"1987","journal-title":"Arch Surg"},{"key":"2024092815363476400_bib9","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/S0167-8140(86)80153-0","article-title":"Conservative treatment of breast cancer in Europe: report of the Groupe Europ\u00e9en de Curieth\u00e9rapie","volume":"6","author":"Pierquin","year":"1986","journal-title":"Radiother Oncol"},{"key":"2024092815363476400_bib10","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1200\/JCO.1991.9.6.988","article-title":"Regional nodal failure after conservative surgery and radiotherapy for early-stage breast carcinoma","volume":"9","author":"Recht","year":"1991","journal-title":"J Clin Oncol"},{"key":"2024092815363476400_bib11","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/0140-6736(91)90475-5","article-title":"Significance of ipsilateral tumour recurrence after lumpectomy","volume":"338","author":"Fisher","year":"1991","journal-title":"Lancet"},{"key":"2024092815363476400_bib12","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1200\/JCO.1993.11.8.1536","article-title":"Impact of axillary lymph node dissection on the therapy of breast cancer patients","volume":"11","author":"Lin","year":"1993","journal-title":"J Clin Oncol"},{"key":"2024092815363476400_bib13","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1056\/NEJM198503143121102","article-title":"Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation","volume":"312","author":"Fisher","year":"1985","journal-title":"N Engl J Med"},{"key":"2024092815363476400_bib14","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1136\/bmj.300.6726.749-d","article-title":"Node negative breast cancer","volume":"300","author":"Leslie","year":"1990","journal-title":"BMJ"},{"key":"2024092815363476400_bib15","first-page":"1116","article-title":"Prognostic value of axillary lymphoscintigraphy in breast carcinoma patients","volume":"27","author":"McClean","year":"1986","journal-title":"J Nucl Med"},{"key":"2024092815363476400_bib16","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1148\/radiology.158.2.3510440","article-title":"Axillary lymph node metastases in breast cancer: preoperative detection with US","volume":"158","author":"Bruneton","year":"1986","journal-title":"Radiology"},{"key":"2024092815363476400_bib17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0140-6736(92)90997-H","article-title":"Systemic treatment of early breast cancer by hormonal, cytotoxic or immune therapy","volume":"339","author":"Early Breast Cancer Trialists' Collaborative Group","year":"1992","journal-title":"Lancet"},{"key":"2024092815363476400_bib18","doi-asserted-by":"crossref","first-page":"S71","DOI":"10.1016\/0959-8049(93)90989-S","article-title":"High-dose chemotherapy (HDC) with autologous progenitor cell support (APCS) for breast cancer patients with high risk stage II-III, and stage IV with no evidence of disease (NED)","volume":"29A","author":"Stemmer","year":"1993","journal-title":"Eur J Cancer"},{"key":"2024092815363476400_bib19","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1002\/bjs.1800720512","article-title":"The efficacy of lower axillary sampling in obtaining lymph node status in breast cancer; a controlled randomised trial","volume":"72","author":"Steele","year":"1985","journal-title":"Br J Surg"},{"key":"2024092815363476400_bib20","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1002\/bjs.1800720511","article-title":"Probability of false negative nodal staging in conjunction with partial axillary dissection in breast cancer","volume":"72","author":"Kjaergaard","year":"1985","journal-title":"Br J Surg"},{"key":"2024092815363476400_bib21","first-page":"127","article-title":"Extent of metastatic axillary involvement in 1446 cases of breast cancer","volume":"16","author":"Veronesi","year":"1990","journal-title":"Eur J Surg Oncol"},{"key":"2024092815363476400_bib22","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1002\/bjs.1800760613","article-title":"Arm morbidity within a trial of mastectomy and either nodal sample with selective radiotherapy or axillary clearance","volume":"76","author":"Aitken","year":"1989","journal-title":"Br J Surg"},{"key":"2024092815363476400_bib23","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/0277-5379(86)90011-8","article-title":"Comparison of Halsted mastectomy with quadrantectomy, axillary dissection, and radiotherapy in early breast cancer: long term results","volume":"22","author":"Veronesi","year":"1986","journal-title":"Eur J Cancer Clin Oncol"},{"key":"2024092815363476400_bib24","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1056\/NEJM198903303201302","article-title":"Eight-year results of a randomised clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer","volume":"320","author":"Fisher","year":"1989","journal-title":"N Engl J Med"},{"key":"2024092815363476400_bib25","doi-asserted-by":"crossref","first-page":"2496","DOI":"10.1002\/1097-0142(19920515)69:10<2496::AID-CNCR2820691018>3.0.CO;2-T","article-title":"A mathematical model of axillary lymph node involvement based on 1446 complete axillary dissections in patients with breast carcinoma","volume":"69","author":"Kiricuta","year":"1992","journal-title":"Cancer"},{"key":"2024092815363476400_bib26","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/0959-8049(92)90534-9","article-title":"Axillary dissection of level I and II lymph nodes is important in breast cancer classification. The Danish Breast Cancer Cooperative Group (DBCG)","volume":"28A","author":"Axelsson","year":"1992","journal-title":"Eur J Cancer"},{"key":"2024092815363476400_bib27","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/0360-3016(87)90060-5","article-title":"Management of the axilla in conservatively treated breast cancer: 592 patients treated at Institut Gustave-Roussy","volume":"13","author":"Dewar","year":"1987","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024092815363476400_bib28","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1016\/S0140-6736(85)91807-0","article-title":"Conservative treatment of breast cancer: results of management of axillary lymph node area in 3353 patients","volume":"i","author":"Mazeron","year":"1985","journal-title":"Lancet"},{"key":"2024092815363476400_bib29","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1038\/bjc.1992.230","article-title":"Assessment of morbidity from complete axillary dissection","volume":"66","author":"Ivens","year":"1992","journal-title":"Br J Cancer"},{"key":"2024092815363476400_bib30","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/0140-6736(92)91591-U","article-title":"Value of axillary dissection in addition to lumpectomy and radiotherapy in early breast cancer","volume":"339","author":"Cabanes","year":"1992","journal-title":"Lancet"},{"key":"2024092815363476400_bib31","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/S0009-9260(88)80061-8","article-title":"The diagnosis by computed tomography of brachial plexus lesions following radiotherapy for carcinoma of the breast","volume":"39","author":"Cooke","year":"1988","journal-title":"Clin Radiol"},{"key":"2024092815363476400_bib32","doi-asserted-by":"crossref","first-page":"237","DOI":"10.3109\/02841869209088909","article-title":"Late effects of radiotherapy in the treatment of breast cancer","volume":"31","author":"Wallgren","year":"1992","journal-title":"Acta Oncol"},{"key":"2024092815363476400_bib33","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1136\/bmj.298.6688.1611","article-title":"Postoperative radiotherapy and late mortality: evidence from the Cancer Research Campaign trial for early breast cancer","volume":"298","author":"Haybittle","year":"1989","journal-title":"BMJ"},{"key":"2024092815363476400_bib34","first-page":"627","volume-title":"Breast Diseases","author":"Petrek","year":"1987"},{"key":"2024092815363476400_bib35","doi-asserted-by":"crossref","first-page":"228","DOI":"10.3109\/02841867509132663","article-title":"Radiation-induced lesions of the brachial plexus correlated to the dose-time-fraction schedule","volume":"14","author":"Svensson","year":"1975","journal-title":"Acta Radiol Thier Phys Biol"},{"key":"2024092815363476400_bib36","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/0167-8140(90)90057-4","article-title":"Radiation-induced brachial plexus injury: follow-up of two different fractionation schedules","volume":"18","author":"Powell","year":"1990","journal-title":"Radiother Oncol"},{"key":"2024092815363476400_bib37","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0936-6555(89)80010-X","article-title":"The Royal College of Radiologists' Fractionation Survey","volume":"1","author":"Priestman","year":"1989","journal-title":"Clin Oncol"},{"key":"2024092815363476400_bib38","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1136\/bmj.1.5491.834","article-title":"Radiation-induced peripheral neuropathy","volume":"i","author":"Stoll","year":"1966","journal-title":"BMJ"},{"key":"2024092815363476400_bib39","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/0360-3016(92)90895-O","article-title":"Long-term radiation complications following conservative surgery (CS) and radiation therapy (RT) in patients with early stage breast cancer","volume":"23","author":"Pierce","year":"1992","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024092815363476400_bib40","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/0360-3016(93)90171-Q","article-title":"Radiation-induced brachial plexopathy: neurological follow-up in 161 recurrence-free breast cancer patients","volume":"26","author":"Olsen","year":"1993","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024092815363476400_bib41","doi-asserted-by":"crossref","first-page":"885","DOI":"10.3109\/02841869009096384","article-title":"Radiation-induced brachial plexus neuropathy in breast cancer patients","volume":"29","author":"Olsen","year":"1990","journal-title":"Acta Oncol"},{"key":"2024092815363476400_bib42","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/0360-3016(90)90157-F","article-title":"Spinal cord radiation \u2018tolerance\u2019: doctrine versus data","volume":"19","author":"Schultheiss","year":"1990","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024092815363476400_bib43","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1002\/1097-0142(197206)29:6<1450::AID-CNCR2820290605>3.0.CO;2-Q","article-title":"Elective irradiation of subclinical disease in cancers of the head and neck","volume":"29","author":"Fletcher","year":"1972","journal-title":"Cancer"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800810906","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/81\/9\/1277\/59413245\/bjs1800810906.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/81\/9\/1277\/59413245\/bjs1800810906.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T15:37:00Z","timestamp":1727537820000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/81\/9\/1277\/6165856"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,9,1]]},"references-count":43,"journal-issue":{"issue":"9","published-online":{"date-parts":[[1994,9,1]]},"published-print":{"date-parts":[[1994,9,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.1800810906","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"type":"print","value":"0007-1323"},{"type":"electronic","value":"1365-2168"}],"subject":[],"published-other":{"date-parts":[[1994,9]]},"published":{"date-parts":[[1994,9,1]]}}}