Sentinel node biopsy in early breast cancer in Taiwan

The purpose of this study is to report the results of sentinel node (SN) biopsy for assessment of early breast cancer in Taiwan and to compare our results with those in other Asian countries and worldwide. We used methylene blue dye to identify SN in patients with clinically non-palpable breast mass and palpable breast mass smaller than 3 cm. We also explored the role of imprint cytology and immunochemical studies to identify metastatic cancer cells in the lymph nodes. A total of 221 procedures on 218 patients were performed by a single surgeon. The SN was identified in 85.5% of the cases. The overall accuracy of identifying tumors in SN was 97.4%, with a sensitivity of 90.9%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 96.4%. The use of immunochemical techniques helped to identify micrometastasis in SN or non-SN. Our results on SN biopsy with the dye method were similar to those reported from Japan and elsewhere. We concluded that sentinel node biopsy, together with the use of immunochemical techniques to identify micrometastatic foci, has allowed surgeons to decide at the time of surgery whether to perform axillary node dissection.