The findings of the SOUND trial, which suggest that some patients with early-stage breast cancer and negative axillary ultrasound can forgo sentinel lymph node (SLN) biopsy without compromising oncologic safety or an adjuvant treatment plan (JAMA Oncol 2023;9[11]:1557-1564), appear to be applicable to a real-world population.
These findings may be helpful for U.S. surgeons who welcome the possibility of further de-escalating breast surgery, but question whether the SOUND