Sentinel lymph node biopsy in breast cancer using radiolabeled sulphur colloid

Purpose:To evaluate the performance and feasibility of sentinel node biopsy (SNB) in breast cancer patients using 99mTc Sulphur colloid and gamma probe.Methods:At Cancer Hospital,from May 2000 30 patients with tumor less than 5 cm with clinically negative axilla underwent SNB, which is followed by standard axillary dissection. 99mTc sulphur colloid was injected around the breast tumor and gamma probe was used to detect the SLN during surgery. SNB is compared with standard axillary dissection for its ability to accurately reflect the final pathological status of the axillary nodes.Results:The sentinel node is successfully identified in 90% (27/30) of the patients. Number of sentinel nodes ranged from 1—3,average 1.5, nonsentinael nodes 5—20,average 13.3 per patient. Of the 27 patients 52%(14/27) were histologically positive. The sentinel node was falsely negative in 2 patients, yielding an accuracy of 92.6%. In T 1 tumors, SNB was more accurate than for T 2 tumors.Conclusions:Gamma probe guided method is technically feasible in detecting sentinel nodes in most cases and predicts the axillary status quite accurately, and appears to be more accurate for T 1 lesions than for larger lesions. This minimally invasive axillary staging procedure represents a major advance in the surgical treatment of breast cancer.