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Although axillary dissection is an excellent procedure for both staging and local control, particularly in the clinically positive axilla, it has considerable morbidity and may understage a significant proportion of patients, because it will usually miss micrometastases that can occur in approximately 10% of \u2018node negative\u2019 patients. An increasing number of patients whose tumours are either non\u2010invasive (ductal carcinoma <jats:italic>in situ;<\/jats:italic> DCIS), micro\u2010invasive, tubular cancers or low\u2010grade T<jats:sub>1a<\/jats:sub> tumours without lymphovascular invasion may be spared axillary surgery because the risk of axillary disease is 0\u20133%. Many studies, both prospective trials and large retrospective series, show that axillary radiotherapy alone provides similar local control rates to axillary dissection in patients with clinically negative axillas. Primary treatment of the axilla with radiotherapy alone, however, does not allow appropriate staging. Sentinel lymph node biopsy is being increasingly used in patients with breast cancer to provide this information. When a sentinel node is identified it is equal to or better than axillary dissection for staging the axilla and, if the node is positive, it will help select patients who should then proceed to further axillary surgery or axillary radiotherapy. Although sentinel lymph node biopsy is being rapidly adopted in many centres worldwide, the results of randomized controlled trials are needed before it can be recommended as the standard of care.<\/jats:p>","DOI":"10.1046\/j.1440-1622.2000.01801.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T02:44:16Z","timestamp":1047350656000},"page":"288-296","source":"Crossref","is-referenced-by-count":9,"title":["Management of the axilla in early breast cancer: is it time to change tack?"],"prefix":"10.1111","volume":"70","author":[{"given":"Philip","family":"Crowe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walley","family":"Templer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2001,12,24]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-190707000-00001"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199511303332202"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1996.01430150079015"},{"key":"e_1_2_6_5_2","unstructured":"MooreMP&KinneDW.Is axillary lymph node dissection necessary in the routine management of breast cancer? 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