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Letters
June 8, 2011

Axillary vs Sentinel Lymph Node Dissection for Invasive Breast Cancer—Reply

Author Affiliations

Author Affiliations: John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California (Dr Giuliano) (giulianoa@jwci.org); Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Morrow); and Mayo Clinic, Rochester, Minnesota (Dr Ballman).

JAMA. 2011;305(22):2288-2291. doi:10.1001/jama.2011.756

In Reply: Dr Jatoi states that ER positivity prolongs time to distant relapse, but studies with extended follow-up do not indicate that it prolongs interval to axillary recurrence.13 Moreover, because the proportion of ER-negative patients was identical in the 2 treatment groups of Z0011 (16.5% ALND, 16.3% SLND alone), the risk of late recurrences should be evenly distributed. Study results are unlikely to change substantially with further follow-up.

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