The changing landscape of axillary surgery: Which breast cancer patients may still benefit from complete axillary lymph node dissection?

Background and Objectives Many breast cancer patients undergoing completion axillary lymph node dissection (CALND) for sentinel lymph node (SLN) metastases have no further disease. Predicting patients at high risk of non‐sentinel lymph node (NSLN) metastasis may help guide effective utilization of CALND. Methods SLN+ breast cancer patients undergoing frozen section (FS) analysis at a single institution (2004–2010) were studied retrospectively. Factors associated with NSLN metastases were identified. Results Two‐hundred forty SLN+ patients were identified. The incidence of NSLN metastases was 45% in FS(+) patients undergoing CALND, compared to 10% of FS(−) patients following CALND (P