目的　探讨蓝色染料和核素方法在乳腺癌前哨淋巴结定位活检中的可靠性、准确性和临床应用价值。方法　运用异硫蓝或99Tc硫胶体结合术中γ探头或联合两种方法对6 1例腋淋巴结阴性的乳腺癌病人进行前哨淋巴结定位活检。结果　前哨淋巴结定位活检总成功率为95 .1% (5 8/ 6 1) ,2例假阴性,假阴性率7.7% ,敏感性92 .3% ,前哨淋巴结预测区域转移准确率96 .6 % ,特异性10 0 .0 %。单用蓝色染料方法的成功率88.2 % ,假阴性率12 .5 % ,敏感性87.5 % ,准确率93.3% ;单用放射核素结合术中γ探头,成功率为95 .2 % ,假阴性率11.1% ,敏感性88.9% ,准确率95 .0 % ;两种方法联合,成功率10 0 .0 % ,无假阴性,敏感性10 0 .0 % ,准确率10 0 .0 %。结论　前哨淋巴结定位活检在乳腺癌中能很好反映腋淋巴结转移状况,对指导乳腺癌腋淋巴结清扫的必要性和合理性有极大的应用价值。蓝色染料和核素探测两者相互补充,可提高前哨淋巴结的成功率和准确率 Objective To investigate the reliability, accuracy and clinical value of blue dye and radionuclide in sentinel lymph node biopsy of breast cancer. Methods Sentinel lymph node biopsy was performed in 61 cases of axillary lymph node-negative breast cancer patients with isothiocyanate or 99Tc sulfur colloid combined with intraoperative gamma probe or a combination of two methods. Results The positive rate of sentinel lymph node localization biopsy was 95.1% (58/61). Two cases were false negative, the false negative rate was 7.7%, the sensitivity was 92.3%, the accuracy of sentinel lymph node metastasis was 96.6% Specificity 100.0%. The success rate was 88.2%, the false negative rate was 12.5%, the sensitivity was 87.5% and the accuracy rate was 93.3% with the blue dye alone method. The radiofrequency alone combined with the intraoperative gamma probe had a success rate of 95.2% The negative rate was 11.1%, the sensitivity was 88.9% and the accuracy rate was 95.0%. The combination of the two methods showed a success rate of 100.0%, no false negative, sensitivity of 100.0% and accuracy of 100.0%. Conclusion Sentinel lymph node biopsy can well reflect the status of axillary lymph node metastasis in breast cancer, which has great value in guiding the necessity and rationality of axillary lymph node dissection in breast cancer. Blue dye and nuclide detection complement each other, can improve the success rate and accuracy of sentinel lymph node