Author Affiliations: Department of Radiation Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey (Dr Fayda) (firstname.lastname@example.org); and Department of Radiation Oncology, University of North Carolina, Chapel Hill (Dr Chen).
To the Editor: In the report of 5-year results of no further axillary treatment vs ALND in patients with early breast cancer with 1 or 2 positive nodes on SLN biopsy,1 it would be helpful to know the rates of isolated tumor cells (ITCs), micrometastasis, and macrometastasis in the involved nodes in the ALND and SLND-alone groups. Chu et al2 performed a retrospective study examining the rates of non-SLN positivity in patients with SLN involvement. The observed rates of additional lymph node positivity during ALND were 0%, 14%, and 55% in patients whose SLN biopsies contained ITCs, micrometastases, and macrometastases, respectively.2
Fayda M, Chen R. Axillary vs Sentinel Lymph Node Dissection for Invasive Breast Cancer. JAMA. 2011;305(22):2288-2291. doi:10.1001/jama.2011.753