The implementation of the sentinel node biopsy as a routine procedure for patients with breast cancer

Background. The sentinel node procedure for breast cancer allows for accura te staging of the axilla while the axillary node dissection can be avoided in patients with no sentinel node metastasis. This study describes those pa tients in whom an axillary dissection is performed, depending on the outcom e of the sentinel node procedure: with particular emphasis on the use of st rict criteria for the procedure and its practical limitations. Methods, Preoperative lymphoscintigraphy was Performed in 115 consecutive p atients The sentinel nodes were located with the use of a gamma probe and b lue dye Axillary dissection was performed at the same time when the sentine l node procedure was positive by frozen section or not successful by the cr iteria used. Results. The sentinel node procedure was successful in 106 patients, with t he sentinel node being both radioactive and blue in 94% of these patients. The frozen section was positive in 21 of 37 patients with sentinel node met astases. Axillary dissection could be avoided in 69 patients. Conclusions. The triple technique (with the use of lymphoscintigraphy, the gamma probe, and the blue dye) gives a high success rate of he sentinel nod e procedure even when strict criteria for a successful sentinel node proced ure are used. Palpation of the open axilla for metastatic nonsentinel nodes is advocated.