If a SNB is positive after neoadjuvant chemo and mastectomy, should an axillary dissection be performed or xrt given to all?  

Just to clarify, the Alliance 011202 study takes patients with involved axillary nodes before induction chemotherapy who fail to convert to node-negativity post-induction, and randomizes them to axillary dissection vs not.  Everyone on the trial gets comprehensive regional RT.  There are o...

All patients with persistent node positive disease after neoadjuvant systemic therapy should receive post mastectomy radiation or following lumpectomy whole breast and regional nodal RT. Ideally if the sentinel node is positive they would go on the alliance trial. Off trial axillary dissection at &n...

The current standard of care is axillary dissection and that is practiced in our hospital. That being said we do end up treating some patients with RT instead of surgery for multiple reasons, with one of them being the patients declining dissection. ALLIANCE is conducting a study where these patien...