No nodal sampling

The advantages of leaving axillary nodes alone during the treatment of breast carcinoma are that it reduces the size of operative intervention. Then, it is possible to treat the occurrence of clinical axillary spread if and when it occurs. In the interim, the patient is monitored carefully and given systemic adjuvant therapy. The underlying theory of this approach is that axillary control does not seem to influence prognosis.

The disadvantage are that:

• radiotherapy may be given to nodes that are not involved
• the oestrogen receptor status of the patient remains unknown and so there can be no rational guidance for giving adjuvant hormonal or chemotherapy