Experience with sentinel node localisation in a district general hospital breast unit

Intraoperative lymphatic mapping with identification of the first draining lymph node (sentinel node) is under investigation as a possible sole axillary staging procedure in breast cancer patients. The role of sentinel node biopsy in the district general hospital breast unit is currently unclear. We report a series of 122 patients undergoing sentinel node biopsy, using a blue dye technique. The sentinel node was identified in 113 patients, and accurately predicted the status of the axilla in 108 patients (96%). Of 39 patients who were node positive, the sentinel node was the only positive node in 11 cases (26%). There were five false negatives in patients who had a node-positive axilla. We therefore suggest that sentinel node biopsy may be a feasible alternative to formal axillary dissection in certain patients, and that lack of access to radioisotope facilities in a district general hospital need not preclude such an approach.