When should the dissected axilla (levels I-II) be included when delivering RNI?

Please see my posting on November 2022 for more details on this subject. To summarize, most of the dissected axilla lies within breast/chest wall tangents, so it is routinely irradiated when RT is used. The upper part of Level 2 is usually outside the tangents and lateral to what is traditionally de...

I largely agree with much of what has been said. To further clarify, I add the following.

1. Traditional axillary dissections removed a "region of tissue" or a "pad of fat" within which the pathologist would look for nodes. So, even if there was extra-nodal extension, there was a reasonable likelihood ...

I think this is an evolving topic, particularly given that we are doing fewer ALNDs. I try to cover the dissected axilla in cases with 4+ nodes involved, ECE/extension into axillary fat, and limited dissection (# nodes/TAD).