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ConclusionThe value of sentinel node biopsy rests on the concept that a single lymph node, or ”sentinel” node is the first of a group of lymph nodes that receives drainage of a specific body segment. In theory, by surveying this single node, tumor movement from the primary site can be predicted for the remainder of the lymph node basin. Should the sentinel node be free of tumor, the remaining lymph nodes of the basin are presumed to be negative, and the patient may be spared axillary lymph node dissection (ALND). If the sentinel node is involved, further lymph nodes in the area may be involved as well.Among the 30 patients with sentinel nodes, the accuracy of the sentinel nodes (the number of cases in which the pathological status of the sentinel nodes corresponded to the pathological status of the axillary nodes, divided by the number of cases) was 92 percent. Whereas the positive predictive value was 100 percent by definition, the negative predictive value was also good, at 84 percent. These results appear to support, at least in part, the hypothesis that the status of the sentinel node can accurately predict whether nodal metastases are present. However, the sensitivity was 89 percent, and the false negative rate for this study was 11.8 percent.Recommendations:To gain the maximum benefits from these procedure it has been advocated to perform a meticulous of patients to reach the least negative rate. It will be optimum to perform these procedures on patients younger than 50 years old, with single tumor mass 2-5 cm. with clinically negative axillary lymph nodes. Also success relies on standardization of various aspects of technique and interactive multidisciplinary team of surgeons, nuclear medicine physicians and pathologists. The results on breast cancer are encouraging but at present this procedure must be in a clinical trial setting. We must to wait the results of ongoing randomized trails before adopting this procedure for routine management of patients with breast cancer.References• Abdullah. T, Iddon. J & Barr. L (1998): Prospective randomized controlled trial of preservation of intercostobrachil nerve during axillary node clearance for breast cancer Br. J. Surgery 85:1443-1445.• Afifi R., Shoukry A. And Saba S. (1997): A strategy for axillary node management in breast cancer patients based on a new practical classification. XXth European Federation Congress Of The International College Of Surgeons. Athens, Greece. Septemper 17th -20th.• Aitkin D. (1993): Complications associated with mastectomy. Surg. Clin. North Am, Vol. 63 p:1331-1352.• AJCC ” American Joint Of Committee Of Cancer ” (1992) : Breast In Manual For Staging Of Cancer, edited by Oliver H. Behars. Lippincott Company, 4th ed., philadilphia, pp.149.• Albertini J J, Lyman G H, Cox C et al (1996): Lymphatic mapping and sentinel lymph node biopsy in patients with breast cancer. JAMA ; 276: 1818-182.• Ansary M. (2001): Her 2/neu gene expression in breast cancer. Abstract of quadripartite congress of Egyptian Society Of Hepatology, International College Of Surgeons, Egyptian Society Of Pediatrics Hepatology And Gastroenterology & Fianco Egyptian Medical Society. Cairo 29th- 31st may.• Axelsson CK, Mouridsen HT, Zedeler K, (1992): on behalf of The Danish Breast Cancer Cooperative Group (DBCG). Axillary dissection of level I and II lymph nodes is important in breast cancer classification. Eur J Cancer; 28A: 1415-1418.• Backer R. (1990): Unusual lesions and their management breast cancer strategies for the 1990s surg. Cin. North. am.; 70: 963.• Baum M. (1995) The breast in: Bailey and Love’s Short practice in surgery, edited by Man C.V., Russell R.C.G., William’s NS, ch., Chapman Hall Medical, pp. 543.• Bliehert M., Rose C. & Andersen J. (1998): Danish randomized trial comparing breast conservation therapy with mastectomy. Danish Breast Cancer Cooperative Group. J. Cancer Inst. Monogr. 11: 19 – 25.• Bondonna G., Valaguussa P. & Moliterni A. (1995): Adjuvant cyclophosphamide, methotrexate and fluorouracil in node positive breast: The results of twenty years of follow up. N. Med. 332: 901-906.• Borgstein P J, Pijpers R, Comans E F. et al (1998): sentinel lymph node biopsy in breast cancer. Guidelines and pitfalls of lymphoscintigraphy and gamma probe detection. J Am Coll surg: 339:
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