Beyond the speed of SOUND

Breast Cancer. 2020 Sep;27(5):793-795. doi: 10.1007/s12282-020-01127-7. Epub 2020 Jun 27.


Much anticipation awaits the results of the SOUND trial, (Gentilini and Veronesi in Breast 21:678-681, 2012) which may prove the futility of performing sentinel node biopsy (SNB) in low-risk breast cancer patients. However, do we really not know the answer to the questions that the SOUND trial poses already? Consideration must be taken of the very much overlooked trials predating the sentinel node era, which risk stratified patients according to the absence of palpable lymphadenopathy and without dependence upon ultrasound imaging (clinically negative axilla). This automatically selects a low-risk group of patients for axillary disease (low axillary burden) and the relevance of these critical trials is discussed.

Publication types

  • Editorial

MeSH terms

  • Axilla
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Evidence-Based Medicine / standards*
  • Female
  • Humans
  • Intraoperative Care / methods
  • Intraoperative Care / standards*
  • Mastectomy / methods
  • Mastectomy / standards
  • Medical Futility*
  • Neoplasm Staging
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic
  • Risk Assessment / methods
  • Risk Assessment / standards
  • Sentinel Lymph Node / diagnostic imaging
  • Sentinel Lymph Node / pathology
  • Sentinel Lymph Node Biopsy / adverse effects
  • Sentinel Lymph Node Biopsy / standards*
  • Ultrasonography