RT Journal
A1 Carlson G, Wood WC
T1 Management of axillary lymph node metastasis in breast cancer: Making progress
JF JAMA
JO JAMA
YR 2011
FD February 9
VO 305
IS 6
SP 606
OP 607
DO 10.1001/jama.2011.131
UL http://dx.doi.org/10.1001/jama.2011.131
AB 
Less is more”—so goes the adage, and that certainly has been the case for breast cancer. Forty years ago, the standard treatment for this disease was the Halsted radical mastectomy, an aggressive operation that involved removal of not only the breast but also the adjacent musculature and axillary lymph nodes. Better understanding of breast cancer biology revealed that aggressive surgical therapy alone was inadequate. As treatment approaches evolved away from extensive surgery, axillary lymph node dissection (ALND) remained part of the treatment regimen to detect nodal disease. Axillary lymph node metastases were considered an indicator that systemic disease was present, identifying a need for chemotherapy.