Do you recommend axillary dissection for women with ER+ breast cancer and low risk Oncotype or Mammaprint if single node positive with only 1-2 SLN removed, to ensure <4 nodes positive?
No, I see no need to do dissection in this setting. Unless there is clinical or imaging evidence of gross disease, radiation should adequately control microscopic residual disease in the axilla.
With six randomized trials for patients with upfront 1-2 SNLN positive (Z011, AMAROS, SINODAR-ONE, OTOASOR, AATRM, and IBCSG) showing ALND doesn’t improve regional control, DFS or OS but adds to morbidity, ALND for this subset, for the most part, is out. The unanswered question or variability is in ...
I am guessing the intent of the question was to determine the need for chemotherapy in 1-3 positive nodes with a low score and whether inadequate dissection would miss those patients with 4 or more nodes to whom RxPONDER would not apply. I am also going to assume this is a postmenopausal woman since...