Delayed Adoption of Evidence-Based Surgical Practices

Management of the axilla has arguably evolved more rapidly than any other area of breast surgery over the past 20 years. Sentinel lymph node (SLN) biopsy superseded axillary lymph node dissection (ALND) for staging the clinically negative axilla and was adopted as the standard of care in the early 2000s after several single-institution and multicenter trials demonstrated test equivalence of SLN biopsy to ALND for axillary staging among patients with early-stage disease.

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