LAUSR

There have been concerns about overtreating the axilla in women with breast cancer at least since publication of the NSABP B04 randomized trial in 1977 [1]. This trial showed that variations in locoregional treatment e including whether or not axillary lymph node dissection (AD) was performed in clinically node negative patients e had no influence on survival. NSABP B04 has had a major influence on surgical approaches the breast, and may be considered a precursor to trials, published in the succeeding decade [2,3], that established breast-conserving surgery (quadrantectomy, lumpectomy) as standard treatment for early breast cancer. As regards the axilla, although AD could be associated with significant morbidity (lymphedema, pain, nerve damage, etc.) moves to a more conservative surgical approach were hampered by the fact that axillary lymph node status was the most important predictor of long-term survival in breast cancer patients and hence an important guide to further treatment [4]. This problem can be considered to have been solved by the development of sentinel lymph node biopsy (SNB) in the 1990s [5]. SNB is a minimallyinvasive procedure with fewer side effects than AD which