Hi Nelie --

I wasn't comparing a neck dissection to a radical mastectomy, I was simply using the latter as an example of the "throwing everything at a cancer" school, as opposed to assessing the best balance between treatment and side-effects.

However many people have had long-term problems from radical neck dissections as done in the past, which is why most surgeons today do modified or selective ND, at least after chemoradiation. RND proved disabling to some, with impacts on shoulder mobility and nerve function etc. Our ENT said she did lots of those while a resident at Hopkins but would almost never consider doing one now.

As to whether they are needed, I guess you have to feel confident the chemoradiation took care of the cancer to decline ND. If you are in doubt or want to be more sure (but still not 100%), get the surgery.

We see our ENT Monday so will report what she says, I will ask her more about the pros and cons from a surgeon's point of view.

Gail