Axillary nodal staging in breast cancer: what have we learned?

Axillary management in patients with breast cancer is in a constant state of evolution. To provide appropriate treatment recommendations, we must understand the historical implications and the current indications for nodal staging as well as the clinical implications of nodal metastases. As we move away from maximal axillary surgical intervention that was previously the mainstay of breast cancer management, future research efforts will focus on targeted therapies based on tumor biology and identifying oncologically safe methods to de-escalate our management strategies.