ALND should be offered to women with sentinel lymph node metastatis who would be undergoing mastectomy,Patients with clinically involved axillary nodes, patient with histologically proven involved axillary lymph node after free-hand or USG guided fine needle aspiration biopsy/core biopsy,Patients with larger tumor having a mastectomy and reconstruction for which a second operation in the axilla or axillary radiotherapy is best avoided.
Diseased Axilla for locoregional control
Patients with clinically involved axillary nodes, patient with histologically proven involved axillary lymph node after free-hand or USG guided fine needle aspiration biopsy/core