Nodal sampling

Axillary nodal sampling during the treatment of breast carcinoma has the aims of removing a few lymph nodes which are examined to indicate involvement with metastasis. This can guide the need for axillary radiotherapy or systemic treatment with chemotherapy or tamoxifen. Nodal sampling is distinct from axillary node clearance where all nodes are removed.

Also, axillary sampling may help to prevent recurrence of disease within the axilla. However, it does not alter the long-term prognosis.

However, there are theoretical problems with axillary nodal sampling:

• there is wide variation in the technique of clearance resulting in widely differing extents of nodal removal; the nodes may not be removed or may be uncharacteristic of the nodal status of the whole axilla
• there may be a greater tendency for local recurrence compared to axillary clearance; there is little clinical evidence that this is true