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Sentinel node biopsy of breast cancer is becoming an increasingly popular topic. The concept of the sentinel node being the first lymph node to contain metastatic cancer within a tumor’s lymphatic basin was introduced by Cabanas, a South American surgeon, following his work on carcinoma of the penis. Morton and his colleagues then applied this principle to malignant melanomas, and more recently this concept has gained popularity for carcinoma of the breast. In breast cancer patients, the fact that a sentinel node can be localized and the suggestion that the sentinel node is representative of the axillary nodal status has been confirmed by a number of studies across the world. Most authors writing on this subject, however, end with a caution that the results of randomized trials are needed before this new surgical technique can be accepted as part of routine breast cancer management. The Medical Research Council of the United Kingdom has funded the audit phase of a multicenter, two phase, randomized trial called the Axillary Lymphatic Mapping Against Nodal Axillary Clearance (ALMANAC) trial, which will compare standard axillary management with sentinel node‐guided axillary management. The aims and protocol of the trial are discussed in detail here.

Scouring by supermassive black hole (SMBH) binaries is the most accepted mechanism for the formation of the cores seen in giant elliptical galaxies. However, an additional mechanism is required to explain the largest observed cores. Gravitational wave (GW) recoil is expected to trigger further growth of the core, as subsequent heating from dynamical friction of the merged SMBH removes stars from the central regions. We model core formation in massive elliptical galaxies from both binary scouring and heating by GW recoil and examine their unique signatures. We aim to determine if the nature of cores in 3D space density can be attributed uniquely to either process and if the magnitude of the kick can be inferred. We perform \\(N\\)-body simulations of galactic mergers of multicomponent galaxies, based on the observed parameters of four massive elliptical galaxies with cores \\(> 0.5\\) kpc. After binary scouring and hardening, the merged SMBH remnant is given a range of GW recoil kicks with \\(0.5\\)-\\(0.9\\) of the escape speed of the galaxy. We find that binary scouring alone can form the cores of NGC 1600 and A2147-BCG, which are \\(< 1.3\\) kpc in size. However, the \\(> 2\\) kpc cores in NGC 6166 and A2261-BCG require heating from GW recoil kicks of \\(< 0.5\\) of the galaxy escape speed. A unique feature of GW recoil heating is flatter cores in surface brightness, corresponding to truly flat cores in 3D space density. It also preferentially removes stars on low angular momentum orbits from the galactic nucleus.