Sentinel node localization in breast cancer patients using intradermal dyeinjection

In a series of 161 consecutive breast cancer operations, intradermal inject ion of Patent Blue was used to localize the sentinel node (SN). The surgica l localization rate was 60%. Including the blue lymph nodes found by the pa thologist, localization rate was 70%. After the first 103 operations, the s urgical procedure was changed, resulting in a localization rate of 83%. Ten surgeons participated,but only one had previous experience with SN dissect ion. The others experienced a steep learning curve. Metastasis was found in 42 of 97 SNs (43%). In 15 cases (36%) metastasis was recognized only after step-sectioning and immunohistochemical staining for cytokeratin. In one c ase a benign epithelial inclusion was found. The sentinel node was false ne gative in 9.1% of cases. The consensus from the literature is that the best results are achieved using a combination of dye and isotopic techniques.