Axillary Disection after positive sentinel node

Wife, 41 yrs., excellent health dignosed with IDC, 1.1 cm;, ER pos,Heu2 neg.,  lumpectomy followed by sentinel node(1) surgery, positive on routine stain < .2mm. Onc recommends aggressive chemo followed by rad. & hormone. How important to do axillary disection if course of action is already most agressive.  Radiation to lymph node area? Wants to avoid further surgery if not a real benefit.

[CCF-RN,MSN-rf]

Dear mitchman:  The primary reason to obtain a full axillary dissection is to determine whether your wife should have axillary radiation.  If she has 4 or more axillary lymph nodes involved, then radiation therapy would be recommended.  This would decrease local recurrence.  If she does not have extensive nodal involvement, then she would not be recommended to have radiation treatment.  Additionally, if she is considering a clinical trial for node positive breast cancer, these trials require a minimum number of lymph nodes to be sampled.