Although en vogue for some time, it seems that many centers especially in Europe are now limiting their indications. In South Korea they have a huge experience and with a transaxillary approach the approach seems better. However indications are so far restricted to small unilateral mostly benign disease. The reported operative time is much longer than equivalent traditional surgery and the risk of RLN injury is also reported to be higher. Another caveat is that the axillary dissection may also jeopardize future conservative approaches for malignant breast disease in females.