The Adventure of Axillary Treatment in Early Stage Breast Cancer

Kuru, Bekir

doi:10.5152/ejbh.2019.5157

The Adventure of Axillary Treatment in Early Stage Breast Cancer

Bekir KURU (Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Samsun, Türkiye)

European Journal of Breast Health

1 0

Yıl: 2020 Cilt: 16 Sayı: 1 Sayfa Aralığı: 1 - 15 Metin Dili: İngilizce DOI: 10.5152/ejbh.2019.5157 İndeks Tarihi: 20-10-2020

The Adventure of Axillary Treatment in Early Stage Breast Cancer

Öz:

Axillary lymph node dissection (ALND) which was an essential part of breast cancer treatment and the gold standard in evaluation of the status ofaxillary lymph node had notorious with increased arm morbidity and reduction of quality of life. Sentinel lymph node biopsy (SLNB) accuratelystages the axilla in early breast cancer and ALND is omitted in SLNB negative patients. In patients with positive SLNB the omission of ALND withor without replacement of axillary radiotherapy has also been recommended by guidelines. The neoadjuvant chemotherapy (NAC) which has beenincreasingly used for large breast cancers to downstage the tumours for allowing breast conserving surgery and decreasing mastectomy rate has alsobeen used in axillary node positive patients to reduce the need for ALND. The issues surrounding the treatment of axilla in patients treated withNAC; application and false negative rate of SLNB, number of identified sentinel lymph nodes, and axillary radiotherapy instead of ALND are currentlythe discussed and practiced hot topics. The quests for decreasing arm morbidity without compromising outcome in breast cancer treatmentwhich have begun with the invention of SLNB continue for axilla conserving surgery. This article reviews the adventure of axillary treatment in breastcancer patients treated with or without NAC.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1. Moore MP, Kinne DW. Axillary lymphadenectomy: a diagnostic and therapeutic procedure. J Surg Oncol 1997; 66: 2-6. (PMID: 9290685)
2. Konkin DE, Tyldesley S, Kennecke H, Speers CH, Olivotto IA, Davis N. Management and outcomes of isolated axillary node recurrence in breast cancer. Arch Surg 2006; 141: 867-872. (PMID: 16983030)
3. Tonellotto F, Bergmann A, de Souza Abrahão K, de Aguiar SS, Bello MA, Thuler LCS. Impact of number of positive lymph nodes and lymph node ratio on survival of women with node-positive breast cancer. Eur J Breast Health 2019; 15: 76-84. (PMID: 31001608)
4. DiSipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol 2013; 14: 500-515. (PMID: 23540561)
5. Ozaslan C, Kuru B. Lymphedema after treatment of breast cancer. Am J Surg 2004; 187: 69-72. (PMID: 14706589)
6. Hayes SC, Rye S, Battistutta D, DiSipio T, Newman B. Upper-body morbidity following breast cancer treatment is common, may persist longer-term and adversely influences quality of life. Health Qual Life Outcomes 2010; 8: 92. (PMID: 20804558)
7. Burstein HJ, Winer EP: Primary care for survivors of breast cancer. N Engl J Med 2000; 343: 1086- 1094. (PMID: 11027744)
8. Larson D, Weinstein M, Goldberg I, Silver B, Recht A, Cady B, Silen W, Harris JR. Edema of the arm as a function of the extent of axillary surgery in patients with stage I-II carcinoma of the breast treated with primary radiotherapy. Int J Radiat Oncol Biol Phys 1986; 12: 1575-1582. (PMID: 3759582)
9. Abass MO, Gismalla MDA, Alsheikh AA, Elhassan MMA. Axillary Lymph Node Dissection for Breast Cancer: Efficacy and Complication in Developing Countries. J Glob Oncol 2018; 4: 1-8. (PMID: 30281378)
10. Berg JW. The significance of axillary node levels in the study of breast carcinoma. Cancer 1955; 8: 776-778. (PMID: 13240660)
11. Cornelissen AJM, Beugels J, Ewalds L, Heuts EM, Keuter XHA, Piatkowski A, van der Hulst RRWJ, Qiu Shao SS. Effect of Lymphaticovenous Anastomosis in Breast Cancer-Related Lymphedema: A Review of the Literature. Lymphat Res Biol 2018; 16: 426-434. (PMID: 29356596)
12. Kodama H, Nio Y, Iguchi C, 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: 811-816. (PMID: 17016485)
13. Tominaga T, Takashima S, 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: 38-43. (PMID: 14716791)
14. Krag DN, Weaver DL, Alex JC, Fairbank JT. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. Surg Oncol 1993; 2: 335-339. (PMID: 8130940)
15. Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 1994; 220: 391-398. (PMID: 8092905)
16. Solà M, Recaj M, Castellà E, Puig P, Gubern JM, Julian JF, Fraile M. Sentinel node biopsy in special histologic types of invasive breast cancer. J Breast Health 2016; 12: 78-82. (PMID: 28331738)
17. Güven HE, Kültüroğlu MO, Gülçelik MA, Özaslan C. Sentinel Lymph node metastasis in invasive lobular carcinoma of the breast. Eur J Breast Health 2018; 14: 117-120. (PMID: 29774321)
18. Kuru B. Echoes from the 40th Annual San Antonio Breast Cancer Symposium, 2017. Eur J Breast Health 2018; 14: 72-73. (PMID: 29774313)
19. Özmen V, Özmen T, Doğru V. Breast Cancer in Turkey; An analysis of 20.000 patients with breast cancer. Eur J Breast Health 2019; 15: 141-146. (PMID: 31312788)
20. Çolakoğlu MK, Güven E, Akgül GG, Doğan L, Gülçelik MA. Biological subtypes of breast cancer and sentinel lymph node biopsy. Eur J Breast Health 2018; 14: 100-104. (PMID: 29774318)
21. Lyman GH, Temin S, Edge SB, Newman LA, Turner RR, Weaver DL, Benson AB 3rd, Bosserman LD, Burstein HJ, Cody H 3rd, Hayman J, Perkins CL, Podoloff DA, Giuliano AE; American Society of Clinical Oncology Clinical Practice. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2014; 32: 1365-1383. (PMID: 24663048)
22. Tafra L, Lannin DR, Swanson MS, Van Eyk JJ, Verbanac KM, Chua AN, Ng PC, Edwards MS, Halliday BE, Henry CA, Sommers LM, Carman CM, Molin MR, Yurko JE, Perry RR, Williams R. Multicenter trial of sentinel node biopsy for breast cancer using both technetium sulfur colloid and isosulfan blue dye. Ann Surg 2001; 233: 51-59. (PMID: 11141225)
23. Veronesi U, Paganelli G, Viale G, Galimberti V, Luini A, Zurrida S, Robertson C, Sacchini V, Veronesi P, Orvieto E, De Cicco C, Intra M, Tosi G, Scarpa D. Sentinel lymph node biopsy and axillary dissection in breast cancer: results in a large series. J Natl Cancer Inst 1999; 91: 368-373. (PMID: 10050871)
24. McMasters KM, Tuttle TM, Carlson DJ, Brown CM, Noyes RD, Glaser RL, Vennekotter DJ, Turk PS, Tate PS, Sardi A, Cerrito PB, Edwards MJ. Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used. J Clin Oncol 2000; 18: 2560-2566. (PMID: 10893287)
25. Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM, Yiangou C, Horgan K, Bundred N, Monypenny I, England D, Sibbering M, Abdullah TI, Barr L, Chetty U, Sinnett DH, Fleissig A, Clarke D, Ell PJ. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst 2006; 98: 599-609. (PMID: 16670385)
26. Kim T, Giuliano AE, Lyman GH. Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a metaanalysis. Cancer 2006; 106: 4-16. (PMID: 16329134)
27. Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Ashikaga T, Weaver DL, Miller BJ, Jalovec LM, Frazier TG, Noyes RD, Robidoux A, Scarth HM, Mammolito DM, McCready DR, Mamounas EP, Costantino JP, Wolmark N; National Surgical Adjuvant Breast and Bowel Project. Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol 2007; 8: 881-888. (PMID: 17851130)
28. Zavagno G, De Salvo GL, Scalco G, Bozza F, Barutta L, Del Bianco P, Renier M, Racano C, Carraro P, Nitti D; GIVOM Trialists. A Randomized clinical trial on sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer: results of the Sentinella/GIVOM trial. Ann Surg 2008; 247: 207-213. (PMID: 18216523)
29. Hunt KK, Yi M, Mittendorf EA, Guerrero C, Babiera GV, Bedrosian I, Hwang RF, Kuerer HM, Ross MI, Meric-Bernstam F. Sentinel lymph node surgery after neoadjuvant chemotherapy is accurate and reduces the need for axillary dissection in breast cancer patients. Ann Surg 2009; 250: 558-566. (PMID: 19730235)
30. Kuru B, Gulcelik MA, Topgul K, Ozaslan C, Dinc S, Dincer H, Bozgul M, Camlibel M, Alagol H. Application of sentinel node biopsy in breast cancer patients with clinically negative and positive axilla and role of axillary ultrasound examination to select patients for sentinel node biopsy. J BUON 2011; 16: 454-459. (PMID: 22006749)
31. Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Costantino JP, Ashikaga T, Weaver DL, Mamounas EP, Jalovec LM, Frazier TG, Noyes RD, Robidoux A, Scarth HM, Wolmark N. 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: 927-933. (PMID: 20863759)
32. Veronesi U, Viale G, Paganelli G, Zurrida S, Luini A, Galimberti V, Veronesi P, Intra M, Maisonneuve P, Zucca F, Gatti G, Mazzarol G, De Cicco C, Vezzoli D. Sentinel lymph node biopsy in breast cancer: ten-year results of a randomized controlled study. Ann Surg 2010; 251: 595-600. (PMID: 20195151) [CrossRef] 33. Hunt KK, Ballman KV, McCall LM, Boughey JC, Mittendorf EA, Cox CE, Whitworth PW, Beitsch PD, Leitch AM, Buchholz TA, Morrow MA, Giuliano AE. Factors associated with local-regional recurrence after a negative sentinel node dissection: results of the ACOSOG Z0010 trial. Ann Surg 2012; 256: 428-436. (MID: 22868365)
34. Pepels MJ, Vestjens JH, de Boer M, Smidt M, van Diest PJ, Borm GF, Tjan-Heijnen VC. Safety of avoiding routine use of axillary dissection in early stage breast cancer: a systematic review. Breast Cancer Res Treat 2011; 125: 301-313. (PMID: 20972825)
35. Galimberti V, Manika A, Maisonneuve P, Corso G, Salazar Moltrasio L, Intra M, Gentilini O, Veronesi P, Pagani G, Rossi E, Bottiglieri L, Viale G, Rotmensz N, De Cicco C, Grana CM, Sangalli C, Luini A. Long-term follow-up of 5262 breast cancer patients with negative sentinel node and no axillary dissection confirms low rate of axillary disease. Eur J Surg Oncol 2014; 40: 1203-1208. (PMID: 25186914)
36. Matsen C, Villegas K, Eaton A, Stempel M, Manning A, Cody HS, Morrow M, Heerdt A. Late Axillary Recurrence After Negative Sentinel Lymph Node Biopsy is Uncommon. Ann Surg Oncol 2016; 23: 2456-2461. (PMID: 26957506)
37. Houvenaeghel G, Classe JM, Garbay JR, Giard S, Cohen M, Faure C, Charytansky H, Rouzier R, Daraï E, Hudry D, Azuar P, Villet R, Gimbergues P, Tunon de Lara C, Martino M, Fraisse J, Dravet F, Chauvet MP, Goncalves A, Lambaudie E. Survival impact and predictive factors of axillary recurrence after sentinel biopsy. Eur J Cancer 2016; 58: 73-82. (PMID: 26971077)
38. de Boniface J, Frisell J, Bergkvist L, Andersson Y. Ten-year report on axillary recurrence after negative sentinel node biopsy for breast cancer from the Swedish Multicentre Cohort Study. Br J Surg 2017; 104: 238-247. (PMID: 28052310)
39. Petrelli F, Lonati V, Barni S. Axillary dissection compared to sentinel node biopsy for the treatment of pathologically node-negative breast cancer: a meta-analysis of four randomized trials with long-term follow up. Oncol Rev 2012; 6: e20. (PMID: 25992218)
40. Chen JJ, Huang XY, Liu ZB, Chen TW, Cheng JY, Yang WT, Xu WP, Shao ZM, Shen ZZ, Wu J. Sentinel node biopsy and quality of life measures in a Chinese population. Eur J Surg Oncol 2009; 35: 921-927. (PMID: 19233602)
41. Purushotham AD, Upponi S, Klevesath MB, Bobrow L, Millar K, Myles JP, Duffy SW. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial. J Clin Oncol 2005; 23: 4312-4321. (PMID: 15994144)
42. Dabakuyo TS, Fraisse J, Causeret S, Gouy S, Padeano MM, Loustalot C, Cuisenier J, Sauzedde JM, Smail M, Combier JP, Chevillote P, Rosburger C, Boulet S, Arveux P, Bonnetain F. A multicenter cohort study to compare quality of life in breast cancer patients according to sentinel lymph node biopsy or axillary lymph node dissection. Ann Oncol 2009; 20: 1352-1361. (PMID: 19468032)
43. Kell MR, Burke JP, Barry M, Morrow M. Outcome of axillary staging in early breast cancer: a meta-analysis.nBreast Cancer Res Treat 2010; 120: 441-447. (PMID: 20063121)
44. Soyder A, Taştaban E, Özbaş S, Boylu Ş, Özgün H. Frequency of early stage lymphedema and risk factors in postoperative patients with breast cancer. J Breast Health 2014; 10: 92-97. (PMID: 28331651)
45. Özçınar B, Güler SA, Kocaman N, Özkan M, Güllüoğlu BM, Özmen V. Complications associated with loco-regional treatment of breast cancer and their impact on quality-of-life. Eur J Breast Health 2018; 15: 51-58. (PMID: 30816353)
46. Kootstra J, Hoekstra-Weebers JE, Rietman H, de Vries J, Baas P, Geertzen JH, Hoekstra HJ. Quality of life after sentinel lymph node biopsy or axillary lymph node dissection in stage I/II breast cancer patients: a prospective longitudinal study. Ann Surg Oncol 2008; 15: 2533-2541. (PMID: 18597146)
47. Sackey H, Magnuson A, Sandelin K, Liljegren G, Bergkvist L, Fülep Z, Celebioglu F, Frisell J. Arm lymphoedema after axillary surgery in women with invasive breast cancer. Br J Surg 2014; 101: 390-397. (PMID: 24536010)
48. Ikeda T. Non-surgical Ablation Therapy for Early-stage Breast Cancer. Kinoshita T, Editor. Surgical procedures in axillary region. Springer Japan; 2016. p.14.
49. Lyman GH, Giuliano AE, Somerfield MR, Benson AB 3rd, Bodurka DC, Burstein HJ, Cochran AJ, Cody HS 3rd, Edge SB, Galper S, Hayman JA, Kim TY, Perkins CL, Podoloff DA, Sivasubramaniam VH, Turner RR, Wahl R, Weaver DL, Wolff AC, Winer EP. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol 2005; 23: 7703-7720. (PMID: 16157938)
50. Armer JM, Ballman KV, McCall L, Ostby PL, Zagar E, Kuerer HM, Hunt KK, Boughey JC. Factors Associated With Lymphedema in Women With Node-Positive Breast Cancer Treated With Neoadjuvant Chemotherapy and Axillary Dissection. JAMA Surg 2019 Jul 17. doi: 10.1001/jamasurg.2019.1742. [Epub ahead of print]
51. Takei H, Suemasu K, Kurosumi M, Horii Y, Yoshida T, Ninomiya J, Yoshida M, Hagiwara Y, Kamimura M, Hayashi Y, Inoue K, Tabei T. Recurrence after sentinel lymph node biopsy with or without axillary lymph node dissection in patients with breast cancer. Breast Cancer 2007; 14: 16-24. (PMID: 17244989)
52. Zakaria S, Pantvaidya G, Reynolds CA, Grant CS, Sterioff S, Donohue JH, Farley DR, Hoskin TL, Degnim AC. Sentinel node positive breast cancer patients who do not undergo axillary dissection: are they different? Surgery 2008; 143: 641-647. (PMID: 18436012)
53. Hwang RF, Gonzalez-Angulo AM, Yi M, Buchholz TA, Meric-Bernstam F, Kuerer HM, Babiera GV, Tereffe W, Liu DD, Hunt KK. Low locoregional failure rates in selected breast cancer patients with tumor-positive sentinel lymphnodes who do not undergo completion axillary dissection. Cancer 2007; 110: 723-730. (PMID: 17587208)
54. Kuru B, Yuruker S, Sullu Y, Gursel B, Ozen N. Management of the Axilla in T1-2 Breast Cancer Patients with Macrometastatic Sentinel Node Involvement Who Underwent Breast-Conserving Therapy. J Invest Surg 2019; 32: 48-54. (PMID: 28945489)
55. Morrow M, Van Zee KJ, Patil S, Petruolo O, Mamtani A, Barrio AV, Capko D, El-Tamer M, Gemignani ML, Heerdt AS, Kirstein L, Pilewskie M, Plitas G, Sacchini VS, Sclafani LM, Ho A, Cody HS. Axillary Dissection and Nodal Irradiation Can Be Avoided for Most Node-positive Z0011-eligible Breast Cancers: A Prospective Validation Study of 793 Patients. Ann Surg 2017; 266: 457-462. (PMID: 28650355)
56. Spiguel L, Yao K, Winchester DJ, Gorchow A, Du H, Sener SF, Martz B, Turk M, Barrera E, Winchester DP. Sentinel node biopsy alone for node-positive breast cancer: 12-year experience at a single institution. J Am Coll Surg 2011; 213: 122-129. (PMID: 21530326)
57. Naik AM, Fey J, Gemignani M, Heerdt A, Montgomery L, Petrek J, Port E, Sacchini V, Sclafani L, VanZee K, Wagman R, Borgen PI, Cody HS 3rd. The risk of axillary relapse after sentinel lymph node biopsy for breast cancer is comparable with that of axillary lymph node dissection: a follow-up study of 4008 procedures. Ann Surg 2004; 240: 462-471. (PMID: 15319717)
58. Park J, Fey JV, Naik AM, Borgen PI, Van Zee KJ, Cody HS 3rd. A declining rate of completion axillary dissection in sentinel lymph node-positive breast cancer patients is associated with the use of a multivariate nomogram. Ann Surg 2007; 245: 462-468. (PMID: 17435554)
59. Tjan-Heijnen VC, Pepels MJ , de Boer M, Borm GF, van Dijck JA, van Deurzen CH. Impact of omission of completion axillary lymph node dissection (cALND) or axillary radiotherapy (ax RT) in breast cancer patients with micrometastases (pN1mi) or isolated tumor cells (pN0[i+]) in the sentinel lymph node (SN): Results from the MIRROR study. American Society of Clinical Oncology 2009, Orlando, FL, 2009, CRA506.
60. Pepels MJ, de Boer M, Bult P, van Dijck JA, van Deurzen CH, Menke-Pluymers MB, van Diest PJ, Borm GF, Tjan-Heijnen VC. Regional recurrence in breast cancer patients with sentinel node micrometastases and isolated tumor cells. Ann Surg 2012; 255: 116-121. (PMID: 22183034)
61. Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V, Godwin J, Gray R, Hicks C, James S, MacKinnon E, McGale P, McHugh T, Peto R, Taylor C, Wang Y. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005; 366: 2087-2106. (PMID: 16360786)
62. Harris JR, Morrow M. How the '4:1 ratio' will likely change with increasing effective systemic therapy. San Antonio Breast Cancer Symposium. San Antonio, TX, 2009, MS3-2. Available from: URL: https://cancerres.aacrjournals.org/content/69/24_Supplement/MS3-2.
63. Bilimoria KY, Bentrem DJ, Hansen NM, Bethke KP, Rademaker AW, Ko CY, Winchester DP, Winchester DJ. Comparison of sentinel lymph node biopsy alone and completion axillary lymph node dissection for node-positive breast cancer. J Clin Oncol 2009; 27: 2946-2953. (PMID: 19364968)
64. Yi M, Giordano SH, Meric-Bernstam F, Mittendorf EA, Kuerer HM, Hwang RF, Bedrosian I, Rourke L, Hunt KK. Trends in and outcomes from sentinel lymph node biopsy (SLNB) alone vs. SLNB with axillary lymph node dissection for node-positive breast cancer patients: experience from the SEER database. Ann Surg Oncol 2010; 17 Suppl 3: 343-351. (PMID: 20853057)
65. Giuliano AE, McCall L, Beitsch P, Whitworth PW, Blumencranz P, Leitch AM, Saha S, Hunt KK, Morrow M, Ballman K. Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 2010; 252: 426-433. (PMID: 20739842)
66. Giuliano AE, Ballman KV, McCall L, Beitsch PD, Brennan MB, Kelemen PR, Ollila DW, Hansen NM, Whitworth PW, Blumencranz PW, Leitch AM, Saha S, Hunt KK, Morrow M. Effect of Axillary Dissection vs No Axillary Dissection on 10-Year Overall Survival Among Women With Invasive Breast Cancer and Sentinel Node Metastasis: The ACOSOG Z0011 (Alliance) Randomized Clinical Trial. JAMA 2017; 318: 918-926. (PMID: 28898379)
67. Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJ, Mansel RE, Cataliotti L, Westenberg AH, Klinkenbijl JH, Orzalesi L, Bouma WH, van der Mijle HC, Nieuwenhuijzen GA, Veltkamp SC, Slaets L, Duez NJ, de Graaf PW, van Dalen T, Marinelli A, Rijna H, Snoj M, Bundred NJ, Merkus JW, Belkacemi Y, Petignat P, Schinagl DA, Coens C, Messina CG, Bogaerts J, Rutgers EJ. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 2014; 15: 1303-1310. (PMID: 25439688)
68. Galimberti V, Cole BF, Viale G, Veronesi P, Vicini E, Intra M, Mazzarol G, Massarut S, Zgajnar J, Taffurelli M, Littlejohn D, Knauer M, Tondini C, Di Leo A, Colleoni M, Regan MM, Coates AS, Gelber RD, Goldhirsch A. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol 2013; 14: 297-305. (PMID: 23491275)
69. Sávolt Á, Péley G, Polgár C, Udvarhelyi N, Rubovszky G, Kovács E, Győrffy B, Kásler M, Mátrai Z. Eight-year follow up result of the OTOASOR trial: The Optimal Treatment Of the Axilla - Surgery Or Radiotherapy after positive sentinel lymph node biopsy in early-stage breast cancer: A randomized, single centre, phase III, non-inferiority trial. Eur J Surg Oncol 2017; 43: 672-679. (PMID: 28139362)
70. Solá M, Alberro JA, Fraile M, Santesteban P, Ramos M, Fabregas R, Moral A, Ballester B, Vidal S. Complete axillary lymph node dissection versus clinical follow-up in breast cancer patients with sentinel node micrometastasis: final results from the multicenter clinical trial AATRM 048/13/2000. Ann Surg Oncol 2013; 20: 120-127. (PMID: 22956062)
71. Dengel LT, Van Zee KJ, King TA, Stempel M, Cody HS, El-Tamer M, Gemignani ML, Sclafani LM, Sacchini VS, Heerdt AS, Plitas G, Junqueira M, Capko D, Patil S, Morrow M. Axillary dissection can be avoided in the majority of clinically node-negative patients undergoing breast-conserving therapy. Ann Surg Oncol 2014; 21: 22-27. (PMID: 23975314)
72. Yi M, Kuerer HM, Mittendorf EA, Hwang RF, Caudle AS, Bedrosian I, Meric-Bernstam F, Wagner JL, Hunt KK. Impact of the American college of surgeons oncology group Z0011 criteria applied to a contemporary patient population. J Am Coll Surg 2013; 216: 105-113. (PMID: 23122536)
73. Roberts A, Nofech-Mozes S, Youngson B, McCready DR, Al-Assi M, Ramkumar S, Cil T. The importance of applying ACOSOG Z0011 criteria in the axillary management of invasive lobular carcinoma: A multi-institutional cohort study. Ann Surg Oncol 2015; 22: 3397-3401. (PMID: 26215196)
74. NCCN. Breast Cancer (Version 1.2019). Available from: URL: https://www.nccn.org/professionals/physician_gls/pdf.breast.pdf
75. Lyman GH, Somerfield MR, Giuliano AE. Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer: 2016 American Society of Clinical Oncology Clinical Practice Guideline Update Summary. J Oncol Pract 2017; 13: 196-198. (PMID: 28118104)
76. Latosinsky S, Berrang TS, Cutter CS, George R, Olivotto I, Julian TB, Hayashi A, Baliski C, Croshaw RL, Erb KM, Chen J. CAGS and ACS evidence based reviews in surgery. 40. Axillary dissection versus no axillary dissection in women with invasive breast cancer and sentinel node metastasis. Can J Surg 2012; 55: 66-69. (PMID: 22269305)
77. Offersen BV, Nielsen HM, Overgaard M, Overgaard J. Is regional nodes radiotherapy an alternative to surgery? Breast 2013; 22 Suppl 2: S118-S128. (PMID: 24074772)
78. Güven HE, Doğan L, Kültüroğlu MO, Gülçelik MA, Özaslan C. Factors influencing non-sentinel node metastases in patients with macrometastatic sentinel lymph node involvement and validation of the commonly used nomograms. Eur J Breast Health 2017; 13: 189-193. (PMID: 29082376)
79. Chung MA, DiPetrillo T, Hernandez S, Masko G, Wazer D, Cady B. Treatment of the axilla by tangential breast radiotherapy in women with invasive breast cancer. Am J Surg 2002; 184: 401-402. (PMID: 12433601)
80. Rabinovitch R, Ballonoff A, Newman F, Finlayson C. Evaluation of breast sentinel lymph node coverage by standard radiation therapy fields. Int J Radiat Oncol Biol Phys 2008; 70: 1468-1471. (PMID: 17967511)
81. Veronesi U, Orecchia R, Zurrida S, Galimberti V, Luini A, Veronesi P, Gatti G, D'Aiuto G, Cataliotti L, Paolucci R, Piccolo P, Massaioli N, Sismondi P, Rulli A, Lo Sardo F, Recalcati A, Terribile D, Acerbi A, Rotmensz N, Maisonneuve P. Avoiding axillary dissection in breast cancer surgery: a randomized trial to assess the role of axillary radiotherapy. Ann Oncol 2005; 16: 383-388. (PMID: 15668261)
82. Whelan TJ, Olivotto IA, Parulekar WR, Ackerman I, Chua BH, Nabid A, Vallis KA, White JR, Rousseau P, Fortin A, Pierce LJ, Manchul L, Chafe S, Nolan MC, Craighead P, Bowen J, McCready DR, Pritchard KI, Gelmon K, Murray Y, Chapman JA, Chen BE, Levine MN; MA.20 Study Investigators. Regional Nodal Irradiation in Early-Stage Breast Cancer. N Engl J Med 2015; 373: 307-316. (PMID: 26200977)
83. Poortmans PM, Collette S, Kirkove C, Van Limbergen E, Budach V, Struikmans H, Collette L, Fourquet A, Maingon P, Valli M, De Winter K, Marnitz S, Barillot I, Scandolaro L, Vonk E, Rodenhuis C, Marsiglia H, Weidner N, van Tienhoven G, Glanzmann C, Kuten A, Arriagada R, Bartelink H, Van den Bogaert W. N Engl J Med 2015; 373: 317-327. (PMID: 26200978)
84. Shaitelman SF, Chiang YJ, Griffin KD, DeSnyder SM, Smith BD, Schaverien MV, Woodward WA, Cormier JN. Radiation therapy targets and the risk of breast cancer-related lymphedema: A systematic review and network meta-analysis. Breast Cancer Res Treat 2017; 162: 201-215. (PMID: 28012086)
85. Sanuki N, Takeda A, Amemiya A, Ofuchi T, Ono M, Ogata H, Yamagami R, Hatayama J, Eriguchi T, Kunieda E. Outcomes of clinically node-negative breast cancer without axillary dissection: Can preserved axilla be safely treated with radiation after a positive sentinel node biopsy? Clin Breast Cancer 2013; 13: 69-76. (PMID: 23062706)
86. Nguyen TT, Hoskin TL, Day CN, Degnim AC, Jakub JW, Hieken TJ, Boughey JC. Decreasing Use of Axillary Dissection in Node-Positive Breast Cancer Patients Treated with Neoadjuvant Chemotherapy. Ann Surg Oncol 2018; 25: 2596-2602. (PMID: 29978369)
87. Tafra L, Verbanac KM, Lannin DR. Preoperative chemotherapy and sentinel lymphadenectomy for breast cancer. Am J Surg 2001; 182: 312-315. (PMID: 11720661)
88. Mamounas EP, Brown A, Anderson S, Smith R, Julian T, Miller B, Bear HD, Caldwell CB, Walker AP, Mikkelson WM, Stauffer JS, Robidoux A, Theoret H, Soran A, Fisher B, Wickerham DL, Wolmark N. Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer: results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol 2005; 23: 2694-2702. (PMID: 15837984)
89. Xing Y, Foy M, Cox DD, Kuerer HM, Hunt KK, Cormier JN. Meta-analysis of sentinel lymph node biopsy after preoperative chemotherapy in patients with breast cancer. Br J Surg 2006; 93: 539-546. (PMID: 16329089)
90. Classe JM, Loaec C, Gimbergues P, Alran S, de Lara CT, Dupre PF, Rouzier R, Faure C, Paillocher N, Chauvet MP, Houvenaeghel G, Gutowski M, De Blay P, Verhaeghe JL, Barranger E, Lefebvre C, Ngo C, Ferron G, Palpacuer C, Campion L. Sentinel lymph node biopsy without axillary lymphadenectomy after neoadjuvant chemotherapy is accurate and safe for selected patients: the GANEA 2 study. Breast Cancer Res Treat 2019; 173: 343-352. (PMID: 30343457)
91. Kelly AM, Dwamena B, Cronin P, Carlos RC. Breast cancer sentinel node identification and classification after neoadjuvant chemotherapy-systematic review and meta analysis. Acad Radiol 2009; 16: 551-563. (PMID: 19345896)
92. Fontein DB, van de Water W, Mieog JS, Liefers GJ, van de Velde CJ. Timing of the sentinel lymph node biopsy in breast cancer patients receiving neoadjuvant therapy - recommendations for clinical guidance. Eur J Surg Oncol 2013; 39: 417-424. (PMID: 23473972)
93. Geng C, Chen X, Pan X, Li J. The Feasibility and Accuracy of Sentinel Lymph Node Biopsy in Initially Clinically Node-Negative Breast Cancer after Neoadjuvant Chemotherapy: A Systematic Review and Meta-Analysis. PLoS One 2016; 11: e0162605. (PMID: 27606623)
94. King TA, Morrow M. Surgical issues in patients with breast cancer receiving neoadjuvant chemotherapy. Nat Rev Clin Oncol 2015; 12: 335-343. (PMID: 25850554)
95. Nogi H, Uchida K, Mimoto R, Kamio M, Shioya H, Toriumi Y, Suzuki M, Nagasaki E, Kobayashi T, Takeyama H. Long-Term Follow-Up of Node-Negative Breast Cancer Patients Evaluated via Sentinel Node Biopsy After Neoadjuvant Chemotherapy. Clin Breast Cancer 2017; 17: 644-649. (PMID: 28601382)
96. Galimberti V, Ribeiro Fontana SK, Maisonneuve P, Steccanella F, Vento AR, Intra M, Naninato P, Caldarella P, Iorfida M, Colleoni M, Viale G, Grana CM, Rotmensz N, Luini A. Sentinel node biopsy after neoadjuvant treatment in breast cancer: Five-year follow-up of patients with clinically node-negative or node-positive disease before treatment. Eur J Surg Oncol 2016; 42: 361-368. (PMID: 26746091)
97. Martelli G, Miceli R, Folli S, Guzzetti E, Chifu C, Maugeri I, Ferranti C, Bianchi G, Capri G, Carcangiu ML, Paolini B, Agresti R, Ferraris C, Piromalli D, Greco M. Sentinel node biopsy after primary chemotherapy in cT2 N0/1 breast cancer patients: Long-term results of a retrospective study. Eur J Surg Oncol 2017; 43: 2012-2020. (PMID: 28912071)
98. Gradishar WJ, Anderson BO, Blair SL, Burstein HJ, Cyr A, Elias AD, Farrar WB, Forero A, Giordano SH, Goldstein LJ, Hayes DF, Hudis CA, Isakoff SJ, Ljung BM, Marcom PK, Mayer IA, McCormick B, Miller RS, Pegram M, Pierce LJ, Reed EC, Salerno KE, Schwartzberg LS, Smith ML, Soliman H, Somlo G, Ward JH, Wolff AC, Zellars R, Shead DA, Kumar R; National Comprehensive Cancer Network Breast Cancer Panel. Breast cancer version 3.2014. J Natl Compr Canc Netw 2014; 12: 542-590. (PMID: 24717572)
99. Mamounas EP, Kuehn T, Rutgers EJT, von Minckwitz G. Current approach of the axilla in patients with early-stage breast cancer. Lancet 2017; S0140-6736: 31451-31454. (PMID: 28818521)
100. Takahashi M, Jinno H, Hayashida T, Sakata M, Asakura K, Kitagawa Y. Correlation between clinical nodal status and sentinel lymph node biopsy false negative rate after neoadjuvant chemotherapy. World J Surg 2012; 36: 2847-2852. (PMID: 22806206)
101. Alvarado R, Yi M, Le-Petross H, Gilcrease M, Mittendorf EA, Bedrosian I, Hwang RF, Caudle AS, Babiera GV, Akins JS, Kuerer HM, Hunt KK. The role for sentinel lymph node dissection after neoadjuvant chemotherapy in patients who present with node-positive breast cancer. Ann Surg Oncol 2012; 19: 3177-3184. (PMID: 22772869)
102. Enokido K, Watanabe C, Nakamura S, Ogiya A, Osako T, Akiyama F, Yoshimura A, Iwata H, Ohno S, Kojima Y, Tsugawa K, Motomura K, Hayashi N, Yamauchi H, Sato N. Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy in Patients With an Initial Diagnosis of Cytology-Proven Lymph Node-Positive Breast Cancer. Clin Breast Cancer 2016; 16: 299-304. (PMID: 26993216)
103. Shen J, Gilcrease MZ, Babiera GV, Ross MI, Meric-Bernstam F, Feig BW, Kuerer HM, Francis A, Ames FC, Hunt KK. Feasibility and accuracy of sentinel lymph node biopsy after preoperative chemotherapy in breast cancer patients with documented axillary metastases. Cancer 2007; 109: 1255-1263. (PMID: 17330229)
104. Fu JF, Chen HL, Yang J, Yi CH, Zheng S. Feasibility and accuracy of sentinel lymph node biopsy in clinically node-positive breast cancer after neoadjuvant chemotherapy: a meta-analysis. PLoS One 2014; 9: e105316. (PMID: 25210779)
105. El Hage Chehade H, Headon H, El Tokhy O, Heeney J, Kasem A, Mokbel K. Is sentinel lymph node biopsy a viable alternative to complete axillary dissection following neoadjuvant chemotherapy in women with node-positive breast cancer at diagnosis? An updated meta-analysis involving 3,398 patients. Am J Surg 2016; 212: 969-981. (PMID: 27671032)
106. Tee SR, Devane LA, Evoy D, Rothwell J, Geraghty J, Prichard RS, McDermott EW. Meta-analysis of sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with initial biopsy-proven node-positive breast cancer. Br J Surg 2018; 105: 1541-1552. (PMID: 30311642)
107. Kuehn T, Bauerfeind I, Fehm T, Fleige B, Hausschild M, Helms G, Lebeau A, Liedtke C, von Minckwitz G, Nekljudova V, Schmatloch S, Schrenk P, Staebler A, Untch M. Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study. Lancet Oncol 2013; 14: 609-618. (PMID: 23683750)
108. Boughey JC, Suman VJ, Mittendorf EA, Ahrendt GM, Wilke LG, Taback B, Leitch AM, Kuerer HM, Bowling M, Flippo-Morton TS, Byrd DR, Ollila DW, Julian TB, McLaughlin SA, McCall L, Symmans WF, Le-Petross HT, Haffty BG, Buchholz TA, Nelson H, Hunt KK; Alliance for Clinical Trials in Oncology. Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: the ACOSOG Z1071 (Alliance) clinical trial. JAMA 2013; 310: 1455-1461. (PMID: 24101169)
109. Boileau JF, Poirier B, Basik M, Holloway CM, Gaboury L, Sideris L, Meterissian S, Arnaout A, Brackstone M, McCready DR, Karp SE, Trop I, Lisbona A, Wright FC, Younan RJ, Provencher L, Patocskai E, Omeroglu A, Robidoux A. Sentinel node biopsy after neoadjuvant chemotherapy in biopsy-proven node-positive breast cancer: the SN FNAC study. J Clin Oncol 2015; 33: 258-264. (PMID: 25452445)
110. Park S, Lee JE, Paik HJ, Ryu JM, Bae SY, Lee SK, Kim SW, Nam SJ. Feasibility and Prognostic Effect of Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy in Cytology-Proven, Node-Positive Breast Cancer. Clin Breast Cancer 2017; 17: e19-e29. (PMID: 27495997)
111. Donker M, Straver ME, Wesseling J, Loo CE, Schot M, Drukker CA, van Tinteren H, Sonke GS, Rutgers EJ, Vrancken Peeters MJ. Marking axillary lymph nodes with radioactive iodine seeds for axillary staging after neoadjuvant systemic treatment in breast cancer patients: the MARI procedure. Ann Surg 2015; 261: 378-382. (PMID: 24743607)
112. Cabioglu N, Karanlık H, Kangal D, Özkurt E, Öner G, Sezen F, Yılmaz R, Tükenmez M, Önder S, İğci A, Özmen V, Dinççağ A, Engin G, Müslümanoğlu M. Improved False-Negative Rates with Intraoperative Identification of Clipped Nodes in Patients Undergoing Sentinel Lymph NodeBiopsy After Neoadjuvant Chemotherapy. Ann Surg Oncol 2018; 25: 3030-3036. (PMID: 29978371)
113. Caudle AS, Yang WT, Krishnamurthy S, Mittendorf EA, Black DM, Gilcrease MZ, Bedrosian I, Hobbs BP, DeSnyder SM, Hwang RF, Adrada BE, Shaitelman SF, Chavez-MacGregor M, Smith BD, Candelaria RP, Babiera GV, Dogan BE, Santiago L, Hunt KK, Kuerer HM. Improved Axillary Evaluation Following Neoadjuvant Therapy for Patients With Node-Positive Breast Cancer Using Selective Evaluation of Clipped Nodes: Implementation of Targeted Axillary Dissection. J Clin Oncol 2016; 34: 1072-1078. (PMID: 26811528)
114. Dominici LS, Negron Gonzalez VM, Buzdar AU, Lucci A, Mittendorf EA, Le-Petross HT, Babiera GV, Meric-Bernstam F, Hunt KK, Kuerer HM. Cytologically proven axillary lymph node metastases are eradicated in patients receiving preoperative chemotherapy with concurrent trastuzumab for HER2-positive breast cancer. Cancer 2010; 116: 2884-2889. (PMID: 20564395)
115. Fisher B, Brown A, Mamounas E, Wieand S, Robidoux A, Margolese RG, Cruz AB Jr, Fisher ER, Wickerham DL, Wolmark N, DeCillis A, Hoehn JL, Lees AW, Dimitrov NV. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol 1997; 15: 2483-2493. (PMID: 9215816)
116. Kuerer HM, Sahin AA, Hunt KK, Newman LA, Breslin TM, Ames FC, Ross MI, Buzdar AU, Hortobagyi GN, Singletary SE. Incidence and impact of documented eradication of breast cancer axillary lymph node metastases before surgery in patients treated with neoadjuvant chemotherapy. Ann Surg 1999; 230: 72-78. (PMID: 10400039)
117. Hennessy BT, Hortobagyi GN, Rouzier R, Kuerer H, Sneige N, Buzdar AU, Kau SW, Fornage B, Sahin A, Broglio K, Singletary SE, Valero V. Outcome after pathologic complete eradication of cytologically proven breast cancer axillary node metastases following primary chemotherapy. J Clin Oncol 2005; 23: 9304-9311. (PMID: 16361629)
118. Choi HJ, Kim I, Alsharif E, Park S, Kim JM, Ryu JM, Nam SJ, Kim SW, Yu J, Lee SK, Lee JE. Use of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Patients with Axillary Node-Positive Breast Cancer in Diagnosis. J Breast Cancer 2018; 21: 433-441. (PMID: 30607165)
119. Kang YJ, Han W, Park S, You JY, Yi HW, Park S, Nam S, Kim JH, Yun KW, Kim HJ, Ahn SH, Park S, Lee JE, Lee ES, Noh DY, Lee JW. Outcome following sentinel lymph node biopsy-guided decisions in breast cancer patients with conversion from positive to negative axillary lymph nodes after neoadjuvant chemotherapy. Breast Cancer Res Treat 2017; 166: 473-480. (PMID: 28766131)
120. Mamounas EP, Anderson SJ, Dignam JJ, Bear HD, Julian TB, Geyer CE Jr, Taghian A, Wickerham DL, Wolmark N. Predictors of locoregional recurrence after neoadjuvant chemotherapy: results from combined analysis of National Surgical Adjuvant Breast and Bowel Project B-18 and B-27. J Clin Oncol 2012; 30: 3960-3966. (PMID: 23032615)
121. Alliance for Clinical Trials in Oncology (Alliance A011202). A Randomized Phase III Trial Evaluating the Role of Axillary Lymph Node Dissection in Breast Cancer Patients (CT1-3 N1) Who Have Positive Sentinel Lymph Node Disease After Neoadjuvant Chemotherapy (online). Available from: URL: https://clinicaltrials.gov/ct2/show/record/NCT01901094.
122. Garg AK, Buchholz TA. Influence of neoadjuvant chemotherapy on radiotherapy for breast cancer. Ann Surg Oncol 2015; 22: 1434-1440. (PMID: 25727554)
123. Nguyen TT, Hieken TJ, Glazebrook KN, Boughey JC. Localizing the Clipped Node in Patients with Node-Positive Breast Cancer Treated with Neoadjuvant Chemotherapy: Early Learning Experience and Challenges. Ann Surg Oncol 2017; 24: 3011-3016. (PMID: 28766234)
124. Morigi C. Highlights from the 15th St Gallen International Breast Cancer Conference 15-18 March, 2017, Vienna: tailored treatments for patients with early breast cancer. Ecancermedicalscience 2017; 11: 732. (PMID: 28491135)
125. Gentilini O, Veronesi U. Abandoning sentinel lymph node biopsy in early breast cancer? A new trial in progress at the European Institute of Oncology of Milan (SOUND: Sentinel node vs Observation after axillary UltraSouND). Breast 2012; 12: 678-681. (PMID: 22835916)
126. Goyal A, Dodwell D. POSNOC: A Randomised Trial Looking at Axillary Treatment in Women with One or Two Sentinel Nodes with Macrometastases. Clin Oncol (R Coll Radiol) 2015; 27: 692-695. (PMID: 26254841)
127. de Boniface J, Frisell J, Andersson Y, Bergkvist L, Ahlgren J, Rydén L, Olofsson Bagge R, Sund M, Johansson H, Lundstedt D. SENOMAC Trialists' Group. Survival and axillary recurrence following sentinel node-positive breast cancer without completion axillary lymph node dissection: the randomized controlled SENOMAC trial. BMC Cancer 2017; 17: 379. (PMID: 28549453)

APA	Kuru B (2020). The Adventure of Axillary Treatment in Early Stage Breast Cancer. , 1 - 15. 10.5152/ejbh.2019.5157
Chicago	Kuru Bekir The Adventure of Axillary Treatment in Early Stage Breast Cancer. (2020): 1 - 15. 10.5152/ejbh.2019.5157
MLA	Kuru Bekir The Adventure of Axillary Treatment in Early Stage Breast Cancer. , 2020, ss.1 - 15. 10.5152/ejbh.2019.5157
AMA	Kuru B The Adventure of Axillary Treatment in Early Stage Breast Cancer. . 2020; 1 - 15. 10.5152/ejbh.2019.5157
Vancouver	Kuru B The Adventure of Axillary Treatment in Early Stage Breast Cancer. . 2020; 1 - 15. 10.5152/ejbh.2019.5157
IEEE	Kuru B "The Adventure of Axillary Treatment in Early Stage Breast Cancer." , ss.1 - 15, 2020. 10.5152/ejbh.2019.5157
ISNAD	Kuru, Bekir. "The Adventure of Axillary Treatment in Early Stage Breast Cancer". (2020), 1-15. https://doi.org/10.5152/ejbh.2019.5157

APA	Kuru B (2020). The Adventure of Axillary Treatment in Early Stage Breast Cancer. European Journal of Breast Health, 16(1), 1 - 15. 10.5152/ejbh.2019.5157
Chicago	Kuru Bekir The Adventure of Axillary Treatment in Early Stage Breast Cancer. European Journal of Breast Health 16, no.1 (2020): 1 - 15. 10.5152/ejbh.2019.5157
MLA	Kuru Bekir The Adventure of Axillary Treatment in Early Stage Breast Cancer. European Journal of Breast Health, vol.16, no.1, 2020, ss.1 - 15. 10.5152/ejbh.2019.5157
AMA	Kuru B The Adventure of Axillary Treatment in Early Stage Breast Cancer. European Journal of Breast Health. 2020; 16(1): 1 - 15. 10.5152/ejbh.2019.5157
Vancouver	Kuru B The Adventure of Axillary Treatment in Early Stage Breast Cancer. European Journal of Breast Health. 2020; 16(1): 1 - 15. 10.5152/ejbh.2019.5157
IEEE	Kuru B "The Adventure of Axillary Treatment in Early Stage Breast Cancer." European Journal of Breast Health, 16, ss.1 - 15, 2020. 10.5152/ejbh.2019.5157
ISNAD	Kuru, Bekir. "The Adventure of Axillary Treatment in Early Stage Breast Cancer". European Journal of Breast Health 16/1 (2020), 1-15. https://doi.org/10.5152/ejbh.2019.5157