Sentinel node staging of early breast cancer using lymphoscintigraphy and the intraoperative gamma-detecting probe

Sentinel node staging for breast cancer is increasingly used in place of ax illary lymph node dissection but is not yet universally accepted. The probl ems of nonstandardized methodologies and lack of consensus on the optimum t echniques to identify sentinel nodes are being addressed. Complementary use of radionuclide imaging before surgery, intraoperative probe detection, an d blue dye have yielded the best reported sensitivities for finding a senti nel node (94%). The importance of imaging is summarized as identifying sent inel node(s), distinguishing sentinel from secondary nodes, guiding surgica l incision planning, and facilitating lower doses, The learning curve pheno menon, which applies to the surgeon and the nuclear medicine physician, has been recognized; measures to minimize it are being implemented. Radiation exposure to operating room and pathology personnel is very low; estimates o f exposure to the surgeon's hands are 0.2% of the annual whole body dose re ceived by every human being from natural background and cosmic sources. Cop yright (C) 2000 by W.B. Saunders Company.