Background: A questionnaire study to document Surgical and Oncological management of Axillary Micrometastases and Isolated Tumour Cells in early-stage breast cancer across the U.K. Methods: A web-based 10-question survey examining management of axillary micrometastases (Mi) and Isolated Tumour Cells (ITCs) in early stage breast cancer was distributed to the membership of the UK Intergroup, a group of 130 breast cancer surgeons and 223 oncologists engaged in clinical breast research. Results: Responses were obtained from 58 breast cancer teams (‘multidisciplinary teams, MDTs’ or ‘tumour boards’), including academic and community-based. Of the 79 responses, 23 (29%) were from surgeons and 56 (71%) from oncologists. 15 centres provided responses from more than one member. For a given question, MDTs for which members gave inconsistent answers were excluded from the analysis. 17 centres (29.3%) reported performing intra-operative assessment of sentinel node biopsies (SNB); 23% Imprint Cytology; 31% PCR and 46% reported using frozen section. Regarding management of Mi, 8 centres (16%) reported performing axillary node clearance (ANC) to level 2 always; 8 centres (16%) clearance to level 3 always, 10 centres (20%) never ANC for Mi and 24 (48%) centres reported sometimes performing ANC. On asking whether centres would consider performing neither ANC nor delivering axillary Radiotherapy (RT) for macrometastases discovered at SNB, 1 centre (2%) reported always, 22 centres (42%) reported never and 29 centres (56%) reported sometimes. Regarding management of ITC’s, 2 centres (3.5%) reported performing ANC, 3 centres (5.3%) delivering RT only and 52 centres (91%) performed neither. The question associated with most inconsistency within an MDT was that which explored giving chemotherapy for patients with Mi or ITCs (80%). Conclusions: In a survey of U.K. breast cancer MDTs, significant variation in management of low volume disease in the axilla was seen. Given the challenge of performing phase 3 trials in this setting, clinicians should be supported to audit treatment and outcomes so the impact of differing protocols on outcomes may be established.