Figure 1:

Current versus Proposed Axillary Staging Protocols

Currently, SLNB is the standard of care for staging of the axilla for patients with early stage breast cancer. However, surgery does not improve survival in patients without clinically apparent disease, and may lead to complications including lymphedema and surgical site infections. In the proposed staging algorithm, negative AUS can be used to exclude disease in the axilla, and identify those patients who can forego SLNB.

AUS: axillary ultrasound, SLNB: sentinel lymph node biopsy, ALND: axillary lymph node dissection.