Would you treat comprehensive nodes in an ER+/PR+/HER2+ breast cancer with an initial biopsied node showing atypia and then pCR (0/2 SLN) on lumpectomy?  

These are challenging cases. I will ask the pathologist if there is any sign of treatment effect in the nodes. If there is, I will treat comprehensively.If no treatment effect, I will discuss the pros/cons with the patient. I do offer and consider given that MA20 showed modest increases in toxicity ...