SENTINEL LYMPHADENECTOMY IN BREAST CANCER: TECHNIQUE AND RESULTS

Axillary lymphatic mapping and sentinel lymphadenectomy is becoming an important surgical technique for assessing 
axillary nodal status in breast cancer. The sentinel lymph node procedure enables selective targeting of the first draining 
lymph node avoiding unnecessary axillary dissection in selected cases. 
Material and methods: 120 patients with operable breast cancer were included in the study period November 1996-June 2000. Patent blue dye was used to map the axilla and identify the sentinel lymph node, which was dissected separately and submitted for histopathologic examination. Completion axillary node dissection was carried out in all cases. Success and accuracy of the technique were evaluated. 
Results: Sentinel lymph node was identified in 100 cases (83%) and accurately predicted axillary status in 99 cases 
(99/100 or 99%). All failures occurred in the first half of the study with none encountered in the second half. There was one false negative case (1%). The positive and negative predictive values of the technique were (100%) and (90.9%) respectively. 
Anatomic level of sentinel lymph node was recorded and 20% of patients (20/100) had the sentinel node located at level II only, which could have been missed by axillary sampling techniques. 
Conclusion: The technique of axillary sentinel lymphadenectomy is accurate providing detailed information about 
axillary status in breast cancer. It could avoid complete axillary dissection in node negative breast cancer patients.