Would you consider an axillary dissection in a young patient with high grade breast cancer and one sentinel LN with isolated tumor cells?  

I agree with @Sushil Beriwal. Although young patients and high grade tumors were less common in ACOSOG Z0011, they were included in the study. There is no data to suggest that they fare any worse with standard adjuvant therapy alone versus ALND. I would proceed with radiation and systemic therapy in...

Current data doesn’t support any need for ALND for ITC unless ITC is after neoadjuvant chemotherapy