Is axillary dissection necessary after positive sentinel node biopsy? Yes!

Axillary dissection has been considered a staging procedure in recent years. Sentinel node biopsy can accurately stage a patient as node-positive or node-negative, raising questions about the need for completion dissection when the sentinel node is positive. This article summarizes data indicating that approximately 50% of patients with sentinel node metastasis have additional positive nodes. For these women, completion axillary dissection provides prognostic information, maintains local control, and may have a survival benefit. Until definitive data from the American College of Surgeons Z11 study is available, completion dissection should remain standard practice.