{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T03:14:26Z","timestamp":1784690066176,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Over the last 30 years, axillary surgery in patients with breast cancer has undergone a consistent patient-centered, evidence-based de-escalation of surgical intervention, including considerable practice changes over the last decade. As surgical approaches change, the role of breast imaging radiologists and axillary imaging must also evolve. Axillary imaging remains variable across radiology practices, with implementation of new protocols occurring at various speeds. Breast radiologists must be aware of recent trials and remain agile in adopting or responding to changing treatment paradigms. Breakthrough studies, such as the SOUND (Sentinel Node Vs Observation After Axillary Ultra-souND) trial, must be vetted and evaluated by individual practices before adoption. Breast radiologists should play a key role in multidisciplinary collaboration with colleagues involved in breast cancer care to assist with strategic planning and appropriate resource utilization.<\/jats:p>","DOI":"10.1093\/jbi\/wbaf021","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T14:01:56Z","timestamp":1748613716000},"page":"474-482","source":"Crossref","is-referenced-by-count":2,"title":["Axillary Surgical De-Escalation: In Tune With the SOUND (Sentinel Node Vs Observation After Axillary Ultra-souND) of Change?"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3115-0090","authenticated-orcid":false,"given":"Santo","family":"Maimone","sequence":"first","affiliation":[{"name":"Department of Radiology, Mayo Clinic Florida , Jacksonville, FL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0545-5165","authenticated-orcid":false,"given":"Brittany","family":"Dashevsky","sequence":"additional","affiliation":[{"name":"Department of Radiology, Stanford University School of Medicine , Palo Alto, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Coffey","sequence":"additional","affiliation":[{"name":"Department of Radiology, Weill Cornell Medicine at New York-Presbyterian , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4606-706X","authenticated-orcid":false,"given":"Kathryn","family":"Zamora","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Alabama at Birmingham , Birmingham, AL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R","family":"Gruen","sequence":"additional","affiliation":[{"name":"Jefferson Radiology, Griffin Hospital , East Hartford, CT ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9138-4385","authenticated-orcid":false,"given":"Katerina","family":"Dodelzon","sequence":"additional","affiliation":[{"name":"Department of Radiology, Weill Cornell Medicine at New York-Presbyterian , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"issue":"5","key":"2025090209172605100_CIT0001","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1148\/rg.2021210053","article-title":"Imaging updates to breast cancer lymph node management","volume":"41","author":"Chung","year":"2021","journal-title":"Radiographics"},{"key":"2025090209172605100_CIT0002","doi-asserted-by":"publisher","first-page":"227","DOI":"10.3389\/fmed.2017.00227","article-title":"Tumor heterogeneity in breast cancer","volume":"4","author":"Turashvili","year":"2017","journal-title":"Front Med (Lausanne)"},{"issue":"6","key":"2025090209172605100_CIT0003","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1148\/rg.336125060","article-title":"Axillary staging of breast cancer: what the radiologist should know","volume":"33","author":"Ecanow","year":"2013","journal-title":"Radiographics"},{"issue":"6","key":"2025090209172605100_CIT0004","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1093\/jbi\/wbab082","article-title":"Axillary imaging following a new invasive breast cancer diagnosis-a radiologist\u2019s dilemma","volume":"3","author":"Dialani","year":"2021","journal-title":"J Breast Imaging"},{"issue":"5","key":"2025090209172605100_CIT0005","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1097\/01.SLA.0000065289.06765.71","article-title":"Axillary lymph node status, but not tumor size, predicts locoregional recurrence and overall survival after mastectomy for breast cancer","volume":"237","author":"Beenken","year":"2003","journal-title":"Ann Surg"},{"issue":"11","key":"2025090209172605100_CIT0006","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1001\/jamaoncol.2023.3759","article-title":"SOUND Trial Group. Sentinel lymph node biopsy vs no axillary surgery in patients with small breast cancer and negative results on ultrasonography of axillary lymph nodes: the SOUND randomized clinical trial","volume":"9","author":"Gentilini","year":"2023","journal-title":"JAMA Oncol"},{"issue":"11","key":"2025090209172605100_CIT0007","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1001\/jamaoncol.2023.3667","article-title":"Sentinel node biopsy for early breast cancer-a SOUND for de-escalation","volume":"9","author":"Khan","year":"2023","journal-title":"JAMA Oncol"},{"issue":"5","key":"2025090209172605100_CIT0008","doi-asserted-by":"publisher","first-page":"2801","DOI":"10.1245\/s10434-024-15010-8","article-title":"At the speed of SOUND: the pace of change for axillary management in breast cancer","volume":"31","author":"Schwartz","year":"2024","journal-title":"Ann Surg Oncol"},{"issue":"6 Suppl","key":"2025090209172605100_CIT0009","doi-asserted-by":"publisher","first-page":"2827","DOI":"10.1002\/1097-0142(197706)39:6&lt;2827::aid-cncr2820390671&gt;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 randomized clinical trial","volume":"39","author":"Fisher","year":"1977","journal-title":"Cancer"},{"issue":"8","key":"2025090209172605100_CIT0010","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1056\/NEJMoa020128","article-title":"Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation","author":"Fisher","year":"2002","journal-title":"N Engl J Med"},{"issue":"10","key":"2025090209172605100_CIT0011","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1016\/S1470-2045(07)70278-4","article-title":"Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial","volume":"8","author":"Krag","year":"2007","journal-title":"Lancet Oncol"},{"issue":"24","key":"2025090209172605100_CIT0012","doi-asserted-by":"publisher","first-page":"3657","DOI":"10.1200\/JCO.2006.07.4062","article-title":"Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011","volume":"25","author":"Lucci","year":"2007","journal-title":"J Clin Oncol"},{"issue":"3","key":"2025090209172605100_CIT0013","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1097\/SLA.0b013e3181f08f32","article-title":"Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial","volume":"252","author":"Giuliano","year":"2010","journal-title":"Ann Surg"},{"issue":"10","key":"2025090209172605100_CIT0014","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1001\/jama.2017.11470","article-title":"Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (Alliance) randomized clinical trial","volume":"318","author":"Giuliano","year":"2017","journal-title":"JAMA"},{"issue":"12","key":"2025090209172605100_CIT0015","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1016\/S1470-2045(14)70460-7","article-title":"Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial","volume":"15","author":"Donker","year":"2014","journal-title":"Lancet Oncol"},{"issue":"12","key":"2025090209172605100_CIT0016","doi-asserted-by":"publisher","first-page":"2159","DOI":"10.1200\/JCO.22.01565","article-title":"Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer: 10-year results of the randomized controlled EORTC 10981-22023 AMAROS trial","volume":"41","author":"Bartels","year":"2023","journal-title":"J Clin Oncol"},{"issue":"25","key":"2025090209172605100_CIT0017","doi-asserted-by":"publisher","first-page":"2336","DOI":"10.1056\/NEJMoa2108873","article-title":"21-gene assay to inform chemotherapy benefit in node-positive breast cancer","volume":"385","author":"Kalinsky","year":"2021","journal-title":"N Engl J Med"},{"issue":"6","key":"2025090209172605100_CIT0018","doi-asserted-by":"publisher","first-page":"3672","DOI":"10.1245\/s10434-024-15111-4","article-title":"SOUND (Sentinel Node Versus Observation After Axillary Ultrasound) trial: are we ready to change the tune of our breast cancer practice","volume":"31","author":"Jakub","year":"2024","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"2025090209172605100_CIT0019","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/j.surg.2023.03.023","article-title":"Omitting axillary staging in selected patients: rationale of choosing wisely in breast cancer treatment","volume":"174","author":"Grossi","year":"2023","journal-title":"Surgery"},{"key":"2025090209172605100_CIT0020","first-page":"139","article-title":"Ultrasound detection of axillary lymph node metastases in breast cancer","volume":"15","author":"Tate","year":"1989","journal-title":"Eur J Surg Oncol"},{"issue":"3","key":"2025090209172605100_CIT0021","doi-asserted-by":"publisher","first-page":"696","DOI":"10.2214\/AJR.12.9036","article-title":"Utility of preoperative ultrasound for predicting pN2 or higher stage axillary lymph node involvement in patients with newly diagnosed breast cancer","volume":"200","author":"Abe","year":"2013","journal-title":"AJR Am J Roentgenol"},{"issue":"9","key":"2025090209172605100_CIT0022","doi-asserted-by":"publisher","first-page":"2239","DOI":"10.1007\/s00268-012-1623-z","article-title":"The false-negative rate of sentinel node biopsy in patients with breast cancer: a meta-analysis","volume":"36","author":"Pesek","year":"2012","journal-title":"World J Surg"},{"issue":"8","key":"2025090209172605100_CIT0023","doi-asserted-by":"publisher","first-page":"4764","DOI":"10.1245\/s10434-022-11829-1","article-title":"Preoperative sonographic prediction of limited axillary disease in patients with primary breast cancer meeting the Z0011 criteria: an alternative to sentinel node biopsy","volume":"29","author":"Radosa","year":"2022","journal-title":"Ann Surg Oncol"},{"issue":"4","key":"2025090209172605100_CIT0024","doi-asserted-by":"publisher","first-page":"iii-iv, 1","DOI":"10.3310\/hta15040","article-title":"Positron emission tomography (PET) and magnetic resonance imaging (MRI) for the assessment of axillary lymph node metastases in early breast cancer: systematic review and economic evaluation","volume":"15","author":"Cooper","year":"2011","journal-title":"Health Technol Assess"},{"key":"2025090209172605100_CIT0025","author":"Society of Surgical Oncology","year":"2016"},{"issue":"14","key":"2025090209172605100_CIT0026","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1001\/jama.2013.278932","article-title":"Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: the ACOSOG Z1071 (Alliance) clinical trial","volume":"310","author":"Boughey","year":"2013","journal-title":"JAMA"},{"issue":"7","key":"2025090209172605100_CIT0027","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1016\/S1470-2045(13)70166-9","article-title":"Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study","volume":"14","author":"Kuehn","year":"2013","journal-title":"Lancet Oncol"},{"issue":"3","key":"2025090209172605100_CIT0028","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1097\/SLA.0000000000000551","article-title":"Factors affecting sentinel lymph node identification rate after neoadjuvant chemotherapy for breast cancer patients enrolled in ACOSOG Z1071 (Alliance)","volume":"261","author":"Boughey","year":"2015","journal-title":"Ann Surg"},{"issue":"3","key":"2025090209172605100_CIT0029","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1097\/SLA.0000000000003075","article-title":"Diagnostic accuracy of different surgical procedures for axillary staging after neoadjuvant systemic therapy in node-positive breast cancer: a systematic review and meta-analysis","volume":"269","author":"Simons","year":"2019","journal-title":"Ann Surg"},{"issue":"6","key":"2025090209172605100_CIT0030","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.2214\/AJR.16.16545","article-title":"Radiologic mapping for targeted axillary dissection: needle biopsy to excision","volume":"207","author":"Shin","year":"2016","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"2025090209172605100_CIT0031","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1007\/s10549-021-06118-6","article-title":"Different strategies in marking axillary lymph nodes in breast cancer patients undergoing neoadjuvant medical treatment: a systematic review","volume":"186","author":"Man","year":"2021","journal-title":"Breast Cancer Res Treat"},{"issue":"11","key":"2025090209172605100_CIT0032","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1056\/NEJMoa2412063","article-title":"Axillary surgery in breast cancer - primary results of the INSEMA trial","volume":"392","author":"Reimer","year":"2025","journal-title":"N Engl J Med"},{"issue":"13","key":"2025090209172605100_CIT0033","doi-asserted-by":"publisher","first-page":"8776","DOI":"10.1245\/s10434-024-16354-x","article-title":"Real world implications of the SOUND trial","volume":"31","author":"Giannakou","year":"2024","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"2025090209172605100_CIT0034","doi-asserted-by":"publisher","first-page":"278","DOI":"10.2214\/AJR.20.25223","article-title":"Breast Cancer Staging: updates in the\u00a0AJCC Cancer Staging Manual, 8th Edition, and current challenges for radiologists, from the\u00a0AJR\u00a0Special Series on Cancer Staging","volume":"217","author":"Teichgraeber","year":"2021","journal-title":"AJR Am J Roentgenol"},{"key":"2025090209172605100_CIT0035","volume-title":"ACR BI-RADS\u00ae Atlas, Breast Imaging Reporting and Data System","author":"D\u2019Orsi","year":"2013"}],"container-title":["Journal of Breast Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jbi\/article-pdf\/7\/4\/474\/63408353\/wbaf021.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbi\/article-pdf\/7\/4\/474\/63408353\/wbaf021.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T13:17:35Z","timestamp":1756819055000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbi\/article\/7\/4\/474\/8154093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":35,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,5,30]]},"published-print":{"date-parts":[[2025,9,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jbi\/wbaf021","relation":{},"ISSN":["2631-6110","2631-6129"],"issn-type":[{"value":"2631-6110","type":"print"},{"value":"2631-6129","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7]]},"published":{"date-parts":[[2025,5,30]]}}}