SENTINEL LYMPH-NODE LOCALIZATION IN EARLY BREAST-CANCER

Methods: Thirty-two patients with clinical node-negative breast cancer underwent sentinel node localization study as part of a National Canc er Institute-sponsored multicenter trial. Anatomical and histopatholog ic characteristics of sentinel lymph node (SLN) and a kinetic analysis of nodal uptake were studied. Patients were injected with 1 mCi/4 mi unfiltered Tc-99m-sulfur colloid in four divided doses around the palp able lesion or immediately adjacent to the excision cavity if prior bi opsy was performed. SLN biopsy was performed 1.5-6 hr (mean = 3 hr) po stinjection. Intraoperative localization was performed using a gamma p robe. All patients underwent complete axillary dissection; Results: SL N was identified in 30 of 32 (94%) patients. There were no false-negat ive SLN biopsies. Conclusion: This study supports the clinical validit y of SLN biopsy in breast cancer and confirms that, unlike the blue dy e technique, the learning curve with unfiltered Tc-99m-sulfur colloid and the gamma detection probe is short, and SLN localization is achiev able in over 90% of cases by surgeons with modest experience. The use of unfiltered (TC)-T-99m-sulfur colloid (larger particle size) with la rger injected volume permits effective localization of SLNs.