目的 :探讨一种在不降低乳腺癌分期准确性的前提下缩小手术的范围的腋窝淋巴结手术方法。方法 :使用专利蓝和美蓝对 1999年 4月～ 2 0 0 0年 4月我院外科收治的 73例临床查体腋窝淋巴结阴性的乳腺癌患者进行哨位淋巴结活检术 (sentinellymphnodebiopsy ,SLNB)。结果 :共成功地确定了 71例( 97.7% )患者的哨位淋巴结 (SLN) ,SLNB的假阴性率为 11.5% ,准确率为 95.8%。患者的年龄、肿瘤大小、肿瘤部位、注射的染料类型及是否活检和术前化疗对成功率和假阴性率无影响。术中印片细胞学检查的准确率为 92 .1% ,假阴性率为 10 % ,假阳性率为 7.1% ;术中快速病理检查准确率为 98 7% ,假阴性率为 5% ,假阳性率为 0 %。免疫组化未发现常规病理检查阴性的SLN有阳性结果。结论 :SLNB能够准确的预测腋窝淋巴结的转移状况 ,在缩小手术范围、减轻患者术后并发症的同时 ,保证了腋窝淋巴结分期的准确性 ;美蓝与专利蓝相比同样可以成功地确定SLN ;术中快速病理检查和印片细胞学检查可以准确的判断SLN的病理状态 ,但也存在一定的假阴性率 Objective: To explore a method of axillary lymph node surgery that reduces the scope of surgery without reducing the accuracy of breast cancer staging. METHODS: Sentinel lymph node biopsy (SLNB) was performed on 73 patients with axillary lymph node-negative breast cancer who were surgically treated in our hospital between April 1999 and April 2000 using patent blue and methylene blue. Results: Sentinel lymph nodes (SLN) were successfully identified in 71 patients (97.7%). The false negative rate of SLNB was 11.5% and the accuracy rate was 95.8%. The patient’s age, tumor size, tumor site, type of dye injected, and whether biopsy and preoperative chemotherapy had no effect on success rate and false negative rate. The accuracy of intraoperative print cytology was 92.1%, the false negative rate was 10%, the false positive rate was 7.1%, the accuracy of intraoperative rapid pathological examination was 98 7%, and the false negative rate was 5%. The positive rate is 0 %. Immunohistochemistry showed no positive results for SLNs that were negative for routine pathological examination. Conclusion: SLNB can accurately predict the metastasis of axillary lymph nodes, reduce the range of surgery, reduce postoperative complications, and ensure the accuracy of axillary lymph node staging. Methylene blue can also successfully determine SLN compared with patent blue. Intraoperative rapid pathological examination and print cytology can accurately determine the pathological state of SLN, but there is also a certain false negative rate