We read with interest the article by Guenther et al1 in which the authors examined the necessity of continuing with axillary lymph node dissection in patients with positive sentinel node breast cancer. The authors observed 46 women with breast cancer with positive sentinel nodes who either were given a recommendation to omit axillary lymph node dissection or refused axillary lymph node dissection despite recommendations to the contrary. In this specific group, no axillary recurrences were noted in a 32-month follow-up. However, we noted with concern that none of the patients except 1 were offered axillary field radiation despite their node-positive status.
Zippel D, Papa M. Patients With Breast Cancer and Positive Sentinel Nodes: Axillary Dissection or Axillary Radiotherapy?. Arch Surg. 2003;138(10):1159. doi:10.1001/archsurg.138.10.1159