[Sentinel lymphonodectomy in breast cancer - our own experience. Part 2]

The aim of this investigation was to document the personal learning curve of the sentinel lymphonodectomy in breast surgery and to compare it with the experiences of other authors.

Between July 1999 and May 2004, the authors performed 218 sentinel lymphonodectomies, 48 of them during the 24-month evaluation period with consecutive full axillary dissection. The overall detection rate was 212/218 or 97.2%, while during the evaluation period it was 38/48 or 89.6% (failures were procedures No. 6, 7, 22, 24 and 47). Among the first 48 cases, 24 had histologically proven metastasis to one or more of the axillary lymph nodes. In 3 of these cases, we were not able to detect a sentinel lymph node, and 4 times the sentinel lymph node was false-negative after rapid section. The false-negative results during the learning period belonged to cases No. 2, 10, 23 and 29 (4/21 or 19%). From September 2001 until May 2004, the detection rate was over 99% (165/166).

Our own experience documents the initial difficulties and insecurities with this operative procedure. The common recommendations, i.e. that sentinel lymphonodectomy without axillary clearance should not be offered before having completed one's own learning curve with the aid of experienced surgeons, are to be supported.