How do you approach an early stage breast cancer patient s/p BCS in which ECE is found on a positive sentinel node?

These are cases that we are facing more commonly and my thought is the answer shouldn't change whether this is BCS or mastectomy (though less data in this setting).

I will discuss with the patient the limitations of Z011 and AMAROS with respect to ENE. With focal microscopic ECE, I will often proceed...

For microscopic ECE, we would do regional nodal RT including 1, 2, 3, and supraclav node instead of ALND.