Identification of sentinel lymph node in breast cancer: experience from the Institut Curie

Sentinel lymph node (SN) biopsy is a recently developed minimally invasive technique for staging the axilla in breast cancer This new procedure of sel ective lymphadenectomy ha; been the subject of several studies, but there i s not currently a consensus of opinion to define which is the best method o f identification. At the Institut Curie since 1996, we have been using the Patent blue dye. The current series present the result of 122 patients with T1, T2, N0 or N1a breast cancer consecutively operated between december 19 97 and august 1998. Sentinel nodes were identified in 107 out of 122 (87.7% ) and accurately predicted auxillary nodal status in 104 out of 107 (97.1%) cases Three out of 35 node positive patients would have been missed with s entinel node biopsy alone, for a false negative rate of 8.5%. In all 3 case s, one lymph node presented with a micrometastases. In 15 cases out of 35 w ith metastatic axillary nodes, the only positive node was the SN (43%). The encouraging results of this study shows that it is possible to identify, i n a large number of cases, the sentinel node by means of Patent blue dye on ly. This article detailed the technique used and reviews the literature con cerning other methods of identification.