Sentinel node biopsy (SNB) is a new component of the surgical treatment of
breast cancer that accurately predicts axillary status. Although the proced
ure is still mainly investigational, many patients are requesting SNB to av
oid axillary dissection if the sentinel node (SN) is negative. From March 1
996 to December 1999, 373 patients with breast carcinoma and clinically neg
ative axillary nodes underwent breast surgery, mainly conservative, and SNB
. If the SN was histologically uninvolved no further surgical treatment was
given. All patients were informed in detail and signed a consent form. SNB
involved injection of labelled albumin particles close to the primary tumo
ur, lymphoscintigraphy and location of the sentinel node with a gamma probe
during surgery. 379 SNBs were performed on 373 patients (6 were bilateral)
. In 94, the SN was positive and complete axillary dissection was performed
. In 285 cases (280 patients) the SN was negative and no dissection was per
formed: these were carefully followed with quarterly clinical examination o
f the axilla. A total of 343 years at risk were available for evaluation fr
om which seven cases of axillary metastases were expected. No cases of clin
ically evident axillary node metastasis have occurred. These findings provi
de further confirmation of the validity of SNB and prompt us to suggest tha
t it should become the method of choice for axillary staging in small-sized
breast cancer. (C) 2001 Elsevier Science Ltd. All rights reserved.