In Reply We thank Guo and colleagues for their comments regarding our study. The importance of unique survivorship needs among patients with breast cancer and the differential impact of more extensive axillary surgery on quality of life (QOL) across racial and ethnic groups cannot be overstated. These differences were highlighted in our prospective lymphedema screening study,1 which demonstrated that Asian, Black, and Hispanic women experienced more subjective arm swelling and worse physical QOL than White women after axillary lymph node dissection.