ABSTRACT
Krag,11 using radioisotope localization, Giuliano,12 using blue dye, and Albertini,13
using a combination of the two methods, have pioneered the application of SLN biopsy to breast cancer. Sandrucci et al reviewed the published results of 4790 SLN biopsy procedures done between 1993 and 1999 using a variety of techniques and reported a wide variation in results.14 Using dye, isotope, and the combina-
tion method, SLNs were found in 65-95%, 67-99%, and 81-95% of patients, respectively, with negative predictive values of 89% to 100%. The results of selected larger series using isotope (with or without blue dye) report greater success (Table 19.1).11,13,15-22
At the European Institute of Oncology in Milan, we began to perform SLN biopsy for breast cancer in March 1996, adopting the radioisotope technique. Here we report the rationale, technique, and results of this methodology as it has evolved over the last 4 years at our center.
