Should axillary imaging be routinely performed in all patients with a new diagnosis of breast cancer?

This issue has been debated but I would argue that patients with a new diagnosis of breast cancer should not undergo routine screening US of the axilla to look for clinically occult disease. The axillary US should be limited to diagnostic imaging for clinically suspicious nodes on clinical exam or breast imaging. All patients who are clinically node negative and taken first to surgery should be eligible for sentinel node biopsy as the appropriate method of staging the axilla.

The concern for rou...