title: [Sentinel node in breast cancer. Experience of the Salah-Azaïz Institute of Tunis].
abstract: BACKGROUND
  Breast cancer screening increased the ratio of small tumours. These tumours have a low lymph node metastatic potential. Sentinel node detection allows detecting axillary lymph node invasion without the morbidity of complete axillary lymph node dissection.
  
  
  OBJECTIVE
  In this study we report the results of the learning curve of sentinel node detection in the Institut Salah-Azaïz of Tunis.
  
  
  METHODS
  It is a prospective study between January 2004 and December 2005 in which 115 patients were included with breast cancer less than 3 cm without antecedents of breast surgery. All these women had sentinel node dissection by a colorimetric method and 30% had a combined method (colorimetric and isotopic).
  
  
  RESULTS
  The rate of detection was 97.3% (n = 112). An extemporaneous examination was performed in 91 patients. The rate of negative forgery of the extemporaneous examination was 4.3% and the sensitivity of 95.7%. There are no false positive with the extemporaneous exam. The sentinel lymph node was the only node invaded in 15 patients (44%). In 3 patients, the sentinel node was healthy whereas the axillary dissection was positive, so the false negative rate is about 2.6%.
  
  
  CONCLUSIONS
  Sentinel node dissection is a reliable and feasible technique. It however requires a training of the surgeon, the pathologist and the nuclear doctor. It allows to reduce the morbidity of the treatment of the breast cancer by avoiding "useless" axillary dissection out in patients without node invasion. The increase in the number of the small cancers discovered during screening makes it possible to increase the number of patients who can profit from this technique.
authors.affiliation: Service de chirurgie carcinologique, institut Salah-Azaïz, boulevard du 9-Avril-1938, Bab-Saadoun 1006, Tunis, Tunisie.
authors.forename: J
authors.initials: J
authors.lastname: Ben Hassouna
authors.forename: T
authors.initials: T
authors.lastname: Bouzid
authors.forename: A
authors.initials: A
authors.lastname: Chkir
authors.forename: N
authors.initials: N
authors.lastname: Kadri
authors.forename: A
authors.initials: A
authors.lastname: Goucha
authors.forename: I
authors.initials: I
authors.lastname: Slim
authors.forename: H
authors.initials: H
authors.lastname: Boussen
authors.forename: A
authors.initials: A
authors.lastname: Gamoudi
authors.forename: M
authors.initials: M
authors.lastname: Hechiche
authors.forename: T
authors.initials: T
authors.lastname: Ben Dhiab
authors.forename: K
authors.initials: K
authors.lastname: Rahal
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D014416:Tunisia