title: Sentinel node biopsy can replace four-node-sampling in staging early breast cancer.
abstract: OBJECTIVE
  Four-node axillary sampling for breast cancer is an established method of staging the axilla in the United Kingdom. We report the sensitivity of sentinel node (SN) biopsy and compare it with that of four-node sampling.
  
  
  METHODS
  SN identification was attempted in 234 consecutive patients with unifocal breast cancers up to 25 mm in diameter on pre-operative ultrasound. A combination of isotope-labelled nanocolloid and patent blue dye techniques were used and SN were identified in 221 (94.5%). All patients underwent back-up four-node sampling and those with positive sentinel nodes on frozen section (FS) underwent immediate full axillary clearance.
  
  
  RESULTS
  Among those patients who had SN successfully identified, an average of 1.38 SN were identified per patient. Histological examination of the SN alone would have identified all node-positive patients that the four-node sample identified.
  
  
  CONCLUSIONS
  In patients who have SN identified, four-node axillary sampling does not provide any additional information.
authors.affiliation: Breast Unit, St. Mary's Hospital, Praed Street, London W2 1NY, UK.
authors.forename: T
authors.initials: T
authors.lastname: Agarwal
authors.forename: S K
authors.initials: SK
authors.lastname: Kakkos
authors.forename: D A
authors.initials: DA
authors.lastname: Cunningham
authors.forename: A
authors.initials: A
authors.lastname: Darzi
authors.forename: D
authors.initials: D
authors.lastname: Lee
authors.forename: P
authors.initials: P
authors.lastname: Rajan
authors.forename: D J
authors.initials: DJ
authors.lastname: Hadjiminas
mesh_terms: D001365:Axilla / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008408:Mastectomy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D013997:Time Factors; D016387:Women's Health