Garcia-Etienne CA, et al. - Researchers derived data from eusomaDB (a central data warehouse of prospectively collected information of the European Society of Breast Cancer Specialists), to analyze the trends in axillary lymph node dissection (ALND) for early-stage breast cancer in Europe over an extended period of time. They found Z0011-criteria (having T1-2 lesions, treated with breast conservation, not received neoadjuvant chemotherapy and have 1–2 positive sentinel nodes) were fulfilled by 6671 patients. From 2010 to 2011, a statistically significant decrease in the rates of ALND was evident, ie, from 89% to 73%, reaching 46% in 2016. Earlier year of surgery, younger age, increasing tumor size and grade, and being operated in Italy were identified as the factors related to higher probability of ALND, following multivariable analysis. In the two centers located in different countries, 0% and 83% were the minimum and maximal rates of ALND in the most recent two-year period (2015–2016). In Europe, spreading unified clinical guidelines is required to allow for homogeneous evidence-based practice trends.