Imaging Protocol and Criteria for Evaluation of Axillary Lymph Nodes in the NAUTILUS Trial

Jung Min Chang, Hee Jung Shin, Ji Soo Choi, Sung Ui Shin, Bo Hwa Choi, Min Jung Kim, Jung Hyun Yoon, Jin Chung, Tae Hee Kim, Boo Kyung Han, Hak Hee Kim, Woo Kyung Moon

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Axillary ultrasonography (US) is the most commonly used imaging modality for nodal evaluation in patients with breast cancer. No Axillary Surgical Treatment in Clinically Lymph Node-Negative Patients after Ultrasonography (NAUTILUS) is a prospective, multicenter, randomized controlled trial investigating whether sentinel lymph node biopsy (SLNB) can be safely omitted in patients with clinically and sonographically node-negative T1–2 breast cancer treated with breast-conserving therapy. In this trial, a standardized imaging protocol and criteria were established for the evaluation of axillary lymph nodes. Women lacking palpable lymph nodes underwent axillary US to dismiss suspicious nodal involvement. Patients with a round hypoechoic node with effaced hilum or indistinct margins were excluded. Patients with T1 tumors and a single node with a cortical thickness ≥ 3 mm underwent US-guided biopsy. Finally, patients with negative axillary US findings were included. The NAUTILUS axillary US nodal assessment criteria facilitate the proper selection of candidates who can omit SLNB. Trial Registration: Identifier: NCT04303715.

Original languageEnglish
Pages (from-to)554-560
Number of pages7
JournalJournal of Breast Cancer
Issue number6
StatePublished - Dec 2021

Bibliographical note

Publisher Copyright:
© 2021 Korean Breast Cancer Society.


  • Breast Neoplasms
  • Sentinel Lymph Node Biopsy
  • Ultrasonography


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