No nodes removed.. is it possible?

That's seems kind of strange to me. I had two suspicious axillary nodes at diagnosis - one was biopsied (negative), but the radiologist considered that "discordant" and recommended excisional biopsy (not done) or biopsy at time of surgery. These days my BS is planning to do the SNB at the time of surgery - which I'm pretty sure is a different group of lymph nodes. She said that if any cancer is found then an axillary disection would be recommended since (she says) outcomes are improved with removal of any cancerous nodes.

Guess I have more questions than answers again!

The general consensus seems to be that the most important part of treatment generally is the surgery. In that vein of thinking I would say get it out and that way you never have to have that hanging over your head. Then again, I'm no doctor and it's not my decision. You may want to get a second opinion or ask for a tumor board.

Personally, I would ask for a SNB, and if positive, axillary dissection. You don't say whether the node that was already removed had been determined to be a sentinel node or not. If it was, then maybe you are OK going without since SNB has already been done.

Steph, I believe that current guidelines allow for omitting axillary node dissection (not removing the underarm lymph nodes) if the nodes are clinically negative after neoadjuvant therapy (chemo before surgery) and radiation will be given to the axilla. In other words, if your nodes appear clear now, they might say you just need radiation. That would be because they think this treatment would be effective without putting you through ALND. I think it is the latest thinking, to spare patients the increased risk of lymphedema that comes with ALND. Just as in the past they used to do a radical mastectomy on everyone, and now they often do a lumpectomy, with just as good results. So do have more conversations with your doctors in order to understand their recommendations for your particular case.