Sentinel node and early breast cancer; identification by blue dye injection. Pilot study.

Study aim: Sentinel node detection in breast cancer can be realized with co lorimetric and isotopic procedures often associated. The aim of this study was to report results obtained with blue dye injection only. Patients and method: From September 1998 to July 1999, blue dye injection w as performed in 73 consecutive patients (mean age: 51 years, range: 36-71 y ears); 51/70 70% were post-menauposal and half of them were under substitut e hormonal treatment; 70% of cancers were discovered through routine mammog raphy. There were 12 bilateral cancers, six of them synchronous, and 84% of cancers were located in the external quadrants. Individualization of senti nel node was performed through blue dye injection into the tumor in case of preoperative diagnosis or in the tumoral site in case of discovery of the cancer through extemporaneous histological examination. Results: 71 out of 73 cancers were classified pT1 and 70% measured 10 mm an d over. Individualization of sentinel node failed in two obese patients. Se ntinel node invasion concerned one node (n = 7), two nodes (n = 1) and thre e nodes (n=1). Conservative treatment was performed in 72 patients out of 7 3; in case of sentinel node invasion, axillary irradiation was performed wi thout reoperation. Conclusion: Blue dye injection for sentinel node individualization is an ac curate technique in selected patients in case of small tumors. Reoperation can be avoided and replaced by axillary irradiation in case of N + tumors. Duration of hospitalization was 48 hours or under in 70/73 patients. Nevert heless isotopic procedure must be recommended as a routine technique in lea rning centers and for most surgical teams. (C) 2000 Editions scientifiques et medicales Elsevier SAS.