Joshi S, et al. - Given that a complete axillary lymph node (ALN) dissection is beneficial in node-positive breast cancer, researchers evaluated the burden of disease in level III axilla by analyzing data for 1,591 consecutive patients with nonmetastatic breast cancer. Level III ALN metastasis was detected in 27.3% (434 of 1,591) patients, with positive interpectoral nodes were detected in 4.7% of patients. Level III metastases in the presence of four or more positive level I and II ALNs were found in 53.2% of patients. In developing countries like India, breast cancer patients exhibited high axillary nodal burden. In level III, residual disease could be detected in one of two women with four or more positive level I and II ALNs, if not cleared during surgery. Physicians should consider intraoperative interpectoral space clearance in cases with either palpable interpectoral lymph nodes or multiple positive ALNs. The factors that enabled the prognostication of disease-free survival independently were histologic grade, four or more positive ALNs, hormone receptor status, and tumor size.