This is such an individual decision. My situation was a little different, as the ND was the first thing done after the diagnosis. The pathology showed the one 3 cm node they knew about, plus some microsocpic infiltration of one other node. No extracapsular spread.

I would personally elect to have the neck dissection, as I wanted to do everything I could to kill this disease once and for all. I would also be concerned somewhat about facing the prospect of multiple surgeries after radiation. While surgeons are getting much better at dealing with radiation tissue damage, and hyperbaric oxygen treatments are available, I would want to minimize the risks there as well.

Sure, there are side effects to an ND, even a MRND. My shoulders are perpetually stiff and sore, and I ache if I have to do anything that requires arms over my head for any length of time. Neck is stiff, and there are all sorts of tics and twinges as the nerves reconnect. However, I am cancer free right now, which was my goal.

A lot depends as to how much risk you can live with. I have a tough enough time as it is, worrying about possible recurrence. If she has the personality to ignore the risk and move on, then not having the ND might be for her.

Again, it's a really individual decision, but I would be sure you had all of the facts and all of the risks carefully noted and explained by the doctors.