Is a completion axillary dissection required for a patient with clinical N+ disease who had a complete clinical response in the axilla to neoadjuvant systemic therapy but is found to ypN+ disease on sentinel node biopsy?

Only a few published studies present sufficiently detailed subgroup data to determine rates of axillary failure or total regional nodal failure for patients having sentinel node biopsy (SNB) after neoadjuvant chemotherapy (NACT) after finding either isolated tumor cells (ITC), micrometastases, or ma...

I would favor dissection as that is SOC for now.

We have selectively done RT but follow up short and most patients had low volume disease

Ling et al., PMID 32280815