Two nomograms were developed for assessing the risk of additional positive nodes. One is from MD. Anderson, one is from Memorial Sloan Kattering, the variables are a little bit different. For example while MD. Anderson nomogram use "extranodal extension of the metastatic lymph node", Memorial not.

So according to the probability of additional node metastasis, you should decide the treatment option. Bruce Haffty has an excellent paper on this topic. I attached. I try to follow his recommendations, but I am very anxious about not treating the supraclavicular lymph nodes in node positive breast cancer patients.

thanks

senem