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Recommendations for staging and managing the axilla

References

 1. National Breast Cancer Centre. Clinical practice guidelines for the management of early breast cancer. 2nd Edition. Canberra: Commonwealth of Australia 2001.

 2. National Breast and Ovarian Cancer Centre. Recommendations for use of sentinel node biopsy in early (operable) breast cancer. Surry Hills: NBOCC 2008.

 3. National Breast Cancer Centre & National Cancer Control Initiative. Clinical practice guidelines for the psychosocial care of adults with cancer. Camperdown: NBCC 2003.

 4. National Health and Medical Research Council. NHMRC additional levels of evidence and grades for recommendations for developers of guidelines. Canberra: Commonwealth of Australia 2009.

 5. National Breast Cancer Centre. Multidisciplinary meetings for cancer care: a guide for health service providers. Camperdown: NBCC 2005.

 6. Mobbs LM, Jannicky EAS, Weaver DL and Harvey SC. The accuracy of sonography in detecting abnormal axillary lymph nodes when breast cancer is present. Journal of Diagnostic Medical Sonography 2005;21(4):297-303.

 7. Bedrosian I, Bedi D, Kuerer HM, et al. Impact of clinicopathological factors on sensitivity of axillary ultrasonography in the detection of axillary nodal metastases in patients with breast cancer. Ann Surg Oncol 2003;10(9):1025-30.

 8. Damera A, Evans AJ, Cornford EJ, et al. Diagnosis of axillary nodal metastases by ultrasound-guided core biopsy in primary operable breast cancer. Br J Cancer 2003;89(7):1310-3.

 9. Motomura K, Inaji H, Komoike Y, et al. Gamma probe and ultrasonographically-guided fine-needle aspiration biopsy of sentinel lymph nodes in breast cancer patients. Eur J Surg Oncol 2001;27(2):141-5.

 10. Sato K, Tamaki K, Tsuda H, et al. Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy. Am J Surg 2004;187(6):679-83.

 11. van Rijk MC, Deurloo EE, Nieweg OE, et al. Ultrasonography and fine-needle aspiration cytology can spare breast cancer patients unnecessary sentinel lymph node biopsy. Ann Surg Oncol 2006;13(1):31-5.

 12. Podkrajsek M, Music MM, Kadivec M, et al. Role of ultrasound in the preoperative staging of patients with breast cancer. Eur Radiol 2005;15(5):1044-50.

 13. Mathijssen IM, Strijdhorst H, Kiestra SK and Wereldsma JC. Added value of ultrasound in screening the clinically negative axilla in breast cancer. J Surg Oncol 2006;94(5):364-7.

 14. Kvistad KA, Rydland J, Smethurst HB, et al. Axillary lymph node metastases in breast cancer: preoperative detection with dynamic contrast-enhanced MRI. Eur Radiol 2000;10(9):1464-71.

 15. Yutani K, Shiba E, Kusuoka H, et al. Comparison of FDG-PET with MIBI-SPECT in the detection of breast cancer and axillary lymph node metastasis. J Comput Assist Tomogr 2000;24(2):274-80.

 16. Barranger E, Grahek D, Antoine M, et al. Evaluation of fluorodeoxyglucose positron emission tomography in the detection of axillary lymph node metastases in patients with early-stage breast cancer. Ann Surg Oncol 2003;10(6):622-7.

 17. Lovrics PJ, Chen V, Coates G, et al. A prospective evaluation of positron emission tomography scanning, sentinel lymph node biopsy, and standard axillary dissection for axillary staging in patients with early stage breast cancer. Ann Surg Oncol 2004;11(9):846-53.

 18. Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 2011;305(6):569-75.***

 19. Tominaga T, Takashima S and Danno M. Randomized clinical trial comparing level II and level III axillary node dissection in addition to mastectomy for breast cancer. Br J Surg 2004;91(1):38-43.

 20. Kodama H, Nio Y, Iguchi C and Kan N. Ten-year follow-up results of a randomised controlled study comparing level-I vs level-III axillary lymph node dissection for primary breast cancer. Br J Cancer 2006;95(7):811-6.

 21. Louis-Sylvestre C, Clough K, Asselain B, et al. Axillary treatment in conservative management of operable breast cancer: dissection or radiotherapy? Results of a randomized study with 15 years of follow-up. J Clin Oncol 2004;22(1):97-101.

 22. Fisher B, Jeong JH, Anderson S, et al. Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Engl J Med 2002;347(8):567-75.

 23. Rudenstam CM, Zahrieh D, Forbes JF, et al. Randomized trial comparing axillary clearance versus no axillary clearance in older patients with breast cancer: first results of International Breast Cancer Study Group Trial 10-93. J Clin Oncol 2006;24(3):337-44.

 24. Martelli G, Boracchi P, De Palo M, et al. A randomized trial comparing axillary dissection to no axillary dissection in older patients with T1N0 breast cancer: results after 5 years of follow-up. Ann Surg 2005;242(1):1-6; discussion 7-9.

 25. Overgaard M, Nielsen HM and Overgaard J. Is the benefit of postmastectomy irradiation limited to patients with four or more positive nodes, as recommended in international consensus reports? A subgroup analysis of the DBCG 82 b&c randomized trials. Radiother Oncol 2007;82(3):247-53.

 26. Truong PT, Woodward WA, Thames HD, et al. The ratio of positive to excised nodes identifies high-risk subsets and reduces inter-institutional differences in locoregional recurrence risk estimates in breast cancer patients with 1-3 positive nodes: an analysis of prospective data from British Columbia and the M. D. Anderson Cancer Center. Int J Radiat Oncol Biol Phys 2007;68(1):59-65.

 27. van der Wal BC, Butzelaar RM, van der Meij S and Boermeester MA. Axillary lymph node ratio and total number of removed lymph nodes: predictors of survival in stage I and II breast cancer. Eur J Surg Oncol 2002;28(5):481-9.

 28. Voordeckers M, Vinh-Hung V, Van de Steene J, et al. The lymph node ratio as prognostic factor in node-positive breast cancer. Radiother Oncol 2004;70(3):225-30.

 29. Vinh-Hung V, Verschraegen C, Promish DI, et al. Ratios of involved nodes in early breast cancer. Breast Cancer Res 2004;6(6):R680-8.

 30. Fortin A, Dagnault A, Blondeau L, et al. The impact of the number of excised axillary nodes and of the percentage of involved nodes on regional nodal failure in patients treated by breast-conserving surgery with or without regional irradiation. Int J Radiat Oncol Biol Phys 2006;65(1):33-9.

 31. Truong PT, Berthelet E, Lee J, et al. The prognostic significance of the percentage of positive/dissected axillary lymph nodes in breast cancer recurrence and survival in patients with one to three positive axillary lymph nodes. Cancer 2005;103(10):2006-14.

 32. Kuru B. Prognostic significance of total number of nodes removed, negative nodes removed, and ratio of positive nodes to removed nodes in node positive breast carcinoma. Eur J Surg Oncol 2006;32(10):1082-8.

 33. Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol 2010;11(10):927-33.***

 34. Lambah A, Dixon JM, Prescott RJ, et al. Randomised study of axillary clearance versus four node sampling. Eur J Cancer 2001;37(Suppl 5):2.

 35. Brancato B, Zappa M, Bricolo D, et al. Role of ultrasound-guided fine needle cytology of axillary lymph nodes in breast carcinoma staging. Radiol Med 2004;108(4):345-55.

 36. Sapino A, Cassoni P, Zanon E, et al. Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management. Br J Cancer 2003;88(5):702-6.

 37. Krishnamurthy S, Sneige N, Bedi DG, et al. Role of ultrasound-guided fine-needle aspiration of indeterminate and suspicious axillary lymph nodes in the initial staging of breast carcinoma. Cancer 2002;95(5):982-8.

 38. Topal U, Punar S, Tasdelen I and Adim SB. Role of ultrasound-guided core needle biopsy of axillary lymph nodes in the initial staging of breast carcinoma. Eur J Radiol 2005;56(3):382-5.

 39. Murray AD, Staff RT, Redpath TW, et al. Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes. Br J Radiol 2002;75(891):220-8.

 40. Greco M, Crippa F, Agresti R, et al. Axillary lymph node staging in breast cancer by 2-fluoro-2-deoxy-D-glucose-positron emission tomography: clinical evaluation and alternative management. J Natl Cancer Inst 2001;93(8):630-5.

 41. Axelsson CK, Rank F, Blichert-Toft M, et al. Impact of axillary dissection on staging and regional control in breast tumors < or = 10 mm--the DBCG experience. The Danish Breast Cancer Cooperative Group (DBCG), Rigshisoutalet, Copenhagen, Denmark. Acta Oncol 2000;39(3):283-9.

 42. Weir L, Speers C, D'Yachkova Y and Olivotto IA. Prognostic significance of the number of axillary lymph nodes removed in patients with node-negative breast cancer. J Clin Oncol 2002;20(7):1793-9.

 43. Mersin H, Yildirim E, Bulut H and Berberoglu U. The prognostic significance of total lymph node number in patients with axillary lymph node-negative breast cancer. Eur J Surg Oncol 2003;29(2):132-8.

 44. Chang DT, Feigenberg SJ, Indelicato DJ, et al. Long-term outcomes in breast cancer patients with ten or more positive axillary nodes treated with combined-modality therapy: the importance of radiation field selection. Int J Radiat Oncol Biol Phys 2007;67(4):1043-51.

 45. Grills IS, Kestin LL, Goldstein N, et al. Risk factors for regional nodal failure after breast-conserving therapy: regional nodal irradiation reduces rate of axillary failure in patients with four or more positive lymph nodes. Int J Radiat Oncol Biol Phys 2003;56(3):658-70.

 46. Johansen J, Overgaard J, Blichert-Toft M and Overgaard M. Treatment of morbidity associated with the management of the axilla in breast-conserving therapy. Acta Oncol 2000;39(3):349-54.

 47. Ragaz J, Olivotto IA, Spinelli JJ, et al. Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J Natl Cancer Inst 2005;97(2):116-26.

 48. Cancer Australia. Management of the axilla for early breast cancer: a systematic review. Surry Hills: Cancer Autralia 2011.

 49. Gebski V, Lagleva M, Keech A, et al. Survival effects of postmastectomy adjuvant radiation therapy using biologically equivalent doses: a clinical perspective. J Natl Cancer Inst 2006;98(1):26-38.

 50. Alvarez S, Anorbe E, Alcorta P, et al. Role of sonography in the diagnosis of axillary lymph node metastases in breast cancer: a systematic review. AJR Am J Roentgenol 2006;186(5):1342-8.

 51. Byrne AM, Hill AD, Skehan SJ, et al. Positron emission tomography in the staging and management of breast cancer. Br J Surg 2004;91(11):1398-409.

 52. Van de Steene J, Soete G and Storme G. Adjuvant radiotherapy for breast cancer significantly improves overall survival: the missing link. Radiother Oncol 2000;55(3):263-72.

 53. Chetty U, Jack W, Prescott RJ, et al. Management of the axilla in operable breast cancer treated by breast conservation: a randomized clinical trial. Edinburgh Breast Unit. Br J Surg 2000;87(2):163-9.

 54. Morgan DA, Berridge J and Blamey RW. Postoperative radiotherapy following mastectomy for high-risk breast cancer. A randomised trial. Eur J Cancer 2002;38(8):1107-10.

 55. Veronesi U, Orecchia R, Zurrida S, et al. Avoiding axillary dissection in breast cancer surgery: a randomized trial to assess the role of axillary radiotherapy. Ann Oncol 2005;16(3):383-8.

 56. Nielsen HM, Overgaard M, Grau C, et al. Loco-regional recurrence after mastectomy in high-risk breast cancer--risk and prognosis. An analysis of patients from the DBCG 82 b&c randomization trials. Radiother Oncol 2006;79(2):147-55.

 57. Nielsen HM, Overgaard M, Grau C, et al. Study of failure pattern among high-risk breast cancer patients with or without postmastectomy radiotherapy in addition to adjuvant systemic therapy: long-term results from the Danish Breast Cancer Cooperative Group DBCG 82 b and c randomized studies. J Clin Oncol 2006;24(15):2268-75.

 58. Rutqvist LE and Johansson H. Long-term follow-up of the Stockholm randomized trials of postoperative radiation therapy versus adjuvant chemotherapy among 'high risk' pre- and postmenopausal breast cancer patients. Acta Oncol 2006;45(5):517-27.

 59. Vinh-Hung V, Burzykowski T, Cserni G, et al. Functional form of the effect of the numbers of axillary nodes on survival in early breast cancer. Int J Oncol 2003;22(3):697-704.

 60. Vinh-Hung V, Cserni G, Burzykowski T, et al. Effect of the number of uninvolved nodes on survival in early breast cancer. Oncol Rep 2003;10(2):363-8.

 61. Megale Costa LJ, Soares HP, Gaspar HA, et al. Ratio between positive lymph nodes and total dissected axillaries lymph nodes as an independent prognostic factor for disease-free survival in patients with breast cancer. Am J Clin Oncol 2004;27(3):304-6.

 62. Truong PT, Lesperance M, Culhaci A, et al. Patient subsets with T1-T2, node-negative breast cancer at high locoregional recurrence risk after mastectomy. Int J Radiat Oncol Biol Phys 2005;62(1):175-82.

 63. Truong PT, Olivotto IA, Kader HA, et al. Selecting breast cancer patients with T1-T2 tumors and one to three positive axillary nodes at high postmastectomy locoregional recurrence risk for adjuvant radiotherapy. Int J Radiat Oncol Biol Phys 2005;61(5):1337-47.

 64. Truong PT, Olivotto IA, Speers CH, et al. A positive margin is not always an indication for radiotherapy after mastectomy in early breast cancer. Int J Radiat Oncol Biol Phys 2004;58(3):797-804.

 65. Kuru B and Bozgul M. The impact of axillary lymph nodes removed in staging of node-positive breast carcinoma. Int J Radiat Oncol Biol Phys 2006;66(5):1328-34.

 66. Saha S, Farrar WB, Young DC, et al. Variation in axillary node dissection influences the degree of nodal involvement in breast cancer patients. J Surg Oncol 2000;73(3):134-7.

 67. Iyer RV, Hanlon A, Fowble B, et al. Accuracy of the extent of axillary nodal positivity related to primary tumor size, number of involved nodes, and number of nodes examined. Int J Radiat Oncol Biol Phys 2000;47(5):1177-83.

 68. Wong JS, O'Neill A, Recht A, et al. The relationship between lymphatic vessell invasion, tumor size, and pathologic nodal status: can we predict who can avoid a third field in the absence of axillary dissection? Int J Radiat Oncol Biol Phys 2000;48(1):133-7.

 69. Kamath VJ, Giuliano R, Dauway EL, et al. Characteristics of the sentinel lymph node in breast cancer predict further involvement of higher-echelon nodes in the axilla: a study to evaluate the need for complete axillary lymph node dissection. Arch Surg 2001;136(6):688-92.

 70. Cserni G. Sentinel lymph-node biopsy-based prediction of further breast cancer metastases in the axilla. Eur J Surg Oncol 2001;27(6):532-8.

 71. Sinha PS, Thrush S, Bendall S and Bates T. Does radical surgery to the axilla give a survival advantage in more severe breast cancer? Eur J Cancer 2002;38(11):1474-7.

 72. Ahlgren J, Holmberg L, Bergh J and Liljegren G. Five-node biopsy of the axilla: an alternative to axillary dissection of levels I-II in operable breast cancer. Eur J Surg Oncol 2002;28(2):97-102.

 73. Chua B, Ung O and Boyages J. Competing considerations in regional nodal treatment for early breast cancer. Breast J 2002;8(1):15-22.

 74. Chua B, Ung O and Boyages J. Treatment of the axilla in early breast cancer: past, present and future. ANZ J Surg 2001;71(12):729-36.

 75. Chua B, Ung O, Taylor R and Boyages J. Is there a role for axillary dissection for patients with operable breast cancer in this era of conservatism? ANZ J Surg 2002;72(11):786-92.

 76. Salama JK, Heimann R, Lin F, et al. Does the number of lymph nodes examined in patients with lymph node-negative breast carcinoma have prognostic significance? Cancer 2005;103(4):664-71.

 77. Fodor J, Polgar C, Major T and Nemeth G. Locoregional failure 15 years after mastectomy in women with one to three positive axillary nodes with or without irradiation the significance of tumor size. Strahlenther Onkol 2003;179(3):197-202.

 78. Kuenen-Boumeester V, Menke-Pluymers M, de Kanter AY, et al. Ultrasound-guided fine needle aspiration cytology of axillary lymph nodes in breast cancer patients. A preoperative staging procedure. Eur J Cancer 2003;39(2):170-4.

 79. Schaapveld M, de Vries EG, van der Graaf WT, et al. The prognostic effect of the number of histologically examined axillary lymph nodes in breast cancer: stage migration or age association? Ann Surg Oncol 2006;13(4):465-74.

 80. Somner JE, Dixon JM and Thomas JS. Node retrieval in axillary lymph node dissections: recommendations for minimum numbers to be confident about node negative status. J Clin Pathol 2004;57(8):845-8.

 81. Kingsmore DB, Hole DJ, Gillis CR and George WD. Axillary recurrence in breast cancer. Eur J Surg Oncol 2005;31(3):226-31.

 82. Kingsmore DB, Ssemwogerere A, Hole DJ, et al. Increased mortality from breast cancer and inadequate axillary treatment. Breast 2003;12(1):36-41.

 83. Shahar KH, Hunt KK, Thames HD, et al. Factors predictive of having four or more positive axillary lymph nodes in patients with positive sentinel lymph nodes: implications for selection of radiation fields. Int J Radiat Oncol Biol Phys 2004;59(4):1074-9.

 84. Gui GP, Joubert DJ, Reichert R, et al. Continued axillary sampling is unnecessary and provides no further information to sentinel node biopsy in staging breast cancer. Eur J Surg Oncol 2005;31(7):707-14.

 85. Tan YY, Fan YG, Lu Y, et al. Ratio of positive to total number of sentinel nodes predicts nonsentinel node status in breast cancer patients. Breast J 2005;11(4):248-53.

 86. Yu JC, Hsu GC, Hsieh CB, et al. Prediction of metastasis to non-sentinel nodes by sentinel node status and primary tumor characteristics in primary breast cancer in Taiwan. World J Surg 2005;29(7):813-8; discussion 818-9.

 87. Katz A, Niemierko A, Gage I, et al. Factors associated with involvement of four or more axillary nodes for sentinel lymph node-positive patients. Int J Radiat Oncol Biol Phys 2006;65(1):40-4.

 88. Tanaka K, Yamamoto D, Kanematsu S, et al. A four node axillary sampling trial on breast cancer patients. Breast 2006;15(2):203-9.

 89. Camp RL, Rimm EB and Rimm DL. A high number of tumor free axillary lymph nodes from patients with lymph node negative breast carcinoma is associated with poor outcome. Cancer 2000;88(1):108-13.

 90. Blancas I, Garcia-Puche JL, Bermejo B, et al. Low number of examined lymph nodes in node-negative breast cancer patients is an adverse prognostic factor. Ann Oncol 2006;17(11):1644-9.

 91. Wada N, Imoto S, Yamauchi C, et al. Predictors of tumour involvement in remaining axillary lymph nodes of breast cancer patients with positive sentinel lymph node. Eur J Surg Oncol 2006;32(1):29-33.

 92. Ciatto S, Brancato B, Risso G, et al. Accuracy of fine needle aspiration cytology (FNAC) of axillary lymph nodes as a triage test in breast cancer staging. Breast Cancer Res Treat 2007;103(1):85-91.

 93. Karlsson P, Cole BF, Price KN, et al. The role of the number of uninvolved lymph nodes in predicting locoregional recurrence in breast cancer. J Clin Oncol 2007;25(15):2019-26.

 94. Millis RR, Springall RJ, Hanby AM, et al. A high number of tumor free axillary lymph nodes from patients with lymph node negative breast carcinoma is associated with poor outcome. Cancer 2002;94(8):2307-9.

 95. Pejavar S, Wilson LD and Haffty BG. Regional nodal recurrence in breast cancer patients treated with conservative surgery and radiation therapy (BCS+RT). Int J Radiat Oncol Biol Phys 2006;66(5):1320-7.

 96. Deurloo EE, Tanis PJ, Gilhuijs KG, et al. Reduction in the number of sentinel lymph node procedures by preoperative ultrasonography of the axilla in breast cancer. Eur J Cancer 2003;39(8):1068-73.

 97. Nori J, Vanzi E, Bazzocchi M, et al. Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy. Am J Surg 2007;193(1):16-20.

 98. Couto D, Dias M, Goncalo M, et al. Diagnostic value of ultrasound and color Doppler in identifying axillary lymph node metastases in patients with breast cancer. Eur J Gynaecol Oncol 2004;25(5):568-70.

 99. Lumachi F, Tregnaghi A, Ferretti G, et al. Accuracy of ultrasonography and 99mTc-sestamibi scintimammography for assessing axillary lymph node status in breast cancer patients. A prospective study. Eur J Surg Oncol 2006;32(9):933-6.

 100. Hinson JL, McGrath P, Moore A, et al. The critical role of axillary ultrasound and aspiration biopsy in the management of breast cancer patients with clinically negative axilla. Ann Surg Oncol 2008;15(1):250-5. Epub 2007.

 101. Ohta M, Tokuda Y, Saitoh Y, et al. Comparative efficacy of positron emission tomography and ultrasonography in preoperative evaluation of axillary lymph node metastases in breast cancer. Breast Cancer 2000;7(1):99-103.

 102. Hubner KF, Smith GT, Thie JA, et al. The Potential of F-18-FDG PET in Breast Cancer. Detection of Primary Lesions, Axillary Lymph Node Metastases, or Distant Metastases. Clin Positron Imaging 2000;3(5):197-205.

 103. Rieber A, Schirrmeister H, Gabelmann A, et al. Pre-operative staging of invasive breast cancer with MR mammography and/or PET: boon or bunk? Br J Radiol 2002;75(898):789-98.

 104. Kelemen PR, Lowe V and Phillips N. Positron emission tomography and sentinel lymph node dissection in breast cancer. Clin Breast Cancer 2002;3(1):73-7.

 105. Guller U, Nitzsche EU, Schirp U, et al. Selective axillary surgery in breast cancer patients based on positron emission tomography with 18F-fluoro-2-deoxy-D-glucose: not yet! Breast Cancer Res Treat 2002;71(2):171-3.

 106. Fehr MK, Hornung R, Varga Z, et al. Axillary staging using positron emission tomography in breast cancer patients qualifying for sentinel lymph node biopsy. Breast J 2004;10(2):89-93.

 107. Wahl RL, Siegel BA, Coleman RE and Gatsonis CG. Prospective multicenter study of axillary nodal staging by positron emission tomography in breast cancer: a report of the staging breast cancer with PET Study Group. J Clin Oncol 2004;22(2):277-85.

 108. Chung A, Liou D, Karlan S, et al. Preoperative FDG-PET for axillary metastases in patients with breast cancer. Arch Surg 2006;141(8):783-8; discussion 788-9.

 109. Kumar R, Zhuang H, Schnall M, et al. FDG PET positive lymph nodes are highly predictive of metastasis in breast cancer. Nucl Med Commun 2006;27(3):231-6.

 110. Gil-Rendo A, Zornoza G, Garcia-Velloso MJ, et al. Fluorodeoxyglucose positron emission tomography with sentinel lymph node biopsy for evaluation of axillary involvement in breast cancer. Br J Surg 2006;93(6):707-12.

 111. Veronesi U, De Cicco C, Galimberti VE, et al. A comparative study on the value of FDG-PET and sentinel node biopsy to identify occult axillary metastases. Ann Oncol 2007;18(3):473-8.

 112. Stadnik TW, Everaert H, Makkat S, et al. Breast imaging. Preoperative breast cancer staging: comparison of USPIO-enhanced MR imaging and 18F-fluorodeoxyglucose (FDC) positron emission tomography (PET) imaging for axillary lymph node staging--initial findings. Eur Radiol 2006;16(10):2153-60.

 113. Schirrmeister H, Kuhn T, Guhlmann A, et al. Fluorine-18 2-deoxy-2-fluoro-D-glucose PET in the preoperative staging of breast cancer: comparison with the standard staging procedures. Eur J Nucl Med 2001;28(3):351-8.

 114. van der Hoeven JJ, Hoekstra OS, Comans EF, et al. Determinants of diagnostic performance of [F-18]fluorodeoxyglucose positron emission tomography for axillary staging in breast cancer. Ann Surg 2002;236(5):619-24.

 115. Kwan W, Jackson J, Weir LM, et al. Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life. J Clin Oncol 2002;20(20):4242-8.

 116. Ververs JM, Roumen RM, Vingerhoets AJ, et al. Risk, severity and predictors of physical and psychological morbidity after axillary lymph node dissection for breast cancer. Eur J Cancer 2001;37(8):991-9.

 117. Livsey JE, Magee B, Stewart AL and Swindell R. Axillary recurrence following conservative surgery and radiotherapy in early breast cancer. Clin Oncol (R Coll Radiol) 2000;12(5):309-14.

 118. Galper S, Recht A, Silver B, et al. Is radiation alone adequate treatment to the axilla for patients with limited axillary surgery? Implications for treatment after a positive sentinel node biopsy. Int J Radiat Oncol Biol Phys 2000;48(1):125-32.

 119. Hoebers FJ, Borger JH, Hart AA, et al. Primary axillary radiotherapy as axillary treatment in breast-conserving therapy for patients with breast carcinoma and clinically negative axillary lymph nodes. Cancer 2000;88(7):1633-42.

 120. Fujimoto N, Amemiya A, Kondo M, et al. Treatment of breast carcinoma in patients with clinically negative axillary lymph nodes using radiotherapy versus axillary dissection. Cancer 2004;101(10):2155-63.

 121. Lee JC, Truong PT, Kader HA, et al. Postmastectomy radiotherapy reduces locoregional recurrence in elderly women with high-risk breast cancer. Clin Oncol (R Coll Radiol) 2005;17(8):623-9.

 122. Eifel P, Axelson JA, Costa J, et al. National Institutes of Health Consensus Development Conference Statement: adjuvant therapy for breast cancer, November 1-3, 2000. J Natl Cancer Inst 2001;93(13):979-89.

 123. Truong PT, Olivotto IA, Whelan TJ and Levine M. Clinical practice guidelines for the care and treatment of breast cancer: 16. Locoregional post-mastectomy radiotherapy. CMAJ 2004;170(8):1263-73.

 124. van la Parra RF, Peer PG, Ernst MF and Bosscha K. Meta-analysis of predictive factors for non-sentinel lymph node metastases in breast cancer patients with a positive SLN. Eur J Surg Oncol 2011;37(4):290-9.***

 125. Fisher B, Montague E, Redmond C, et al. Comparison of radical mastectomy with alternative treatments for primary breast cancer. A first report of results from a prospective randomized clinical trial. Cancer 1977;39(6 Suppl):2827-39.

 126. National Breast and Ovarian Cancer Centre. The management of secondary lymphoedema - a guide for health professionals. Surry Hills: NBOCC 2008.

 127. National Breast and Ovarian Cancer Centre. Review of research evidence on secondary lymphoedema: Incidence, prevention, risk factors and treatment. Surry Hills: NBOCC 2008.

 128. Gill G. Sentinel-lymph-node-based management or routine axillary clearance? One-year outcomes of sentinel node biopsy versus axillary clearance (SNAC): a randomized controlled surgical trial. Ann Surg Oncol 2009;16(2):266-75.***

 129. Australian New Zealand Clinical Trials Registry. Trial details - SNAC2. Accessed: November 2007 www.anzctr.org.au/trial_view.aspx?ID=484.

 130. National Cancer Institute. Clinical Trials PDQ. EORTC 10981. Accessed: June 2007 http://www.cancer.gov/clinicaltrials/EORTC-10981.

 131. National Cancer Institute. Clinical Trials PDQ. IBCSG-23-01. Accessed: June 2007 http://www.cancer.gov/clinicaltrials/IBCSG-23-01.

***These articles were considered by NBOCC's Axilla working group but were published after July 2007.

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