<p>Current de-escalation studies on axillary surgery for breast cancer in various clinical scenarios are investigating whether it is possible to reduce axillary interventions or even omit axillary surgery entirely in selected patients without compromising oncological outcomes. Existing study results clearly show that less invasive approaches to breast cancer treatment can be safe and effective in selected patients. De-escalation of axillary surgery reduces complications and improves patients’ quality of life without compromising overall oncological cure rates. The integration of de-escalation strategies into clinical practice could bring about a paradigm shift in breast cancer treatment and pose new challenges for breast centers regarding the direction of interdisciplinary therapy.</p>