Would you pursue ALND in a patient with breast cancer who had a negative sentinel node biopsy but had a non-sentinel node that was positive?

If the patient had a clinically negative axilla and otherwise meets criteria for Z0011, I would probably omit completion ALND in the setting of an incidentally identified non-sentinel node at the time of sentinel node biopsy. We know that the sentinel node biopsy carries a false negative rate of app...