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Summary: Background: Sentinel lymph node biopsy seems to be a promising new method for determining axillary status in breast cancer. The method helps to reduce morbidity, and an increased number of micrometastases are detected in the sentinel nodes by which patients with a less favourable outcome are identified. However, no long‐term follow‐up data is available. 
Methods: Data from 1567 breast cancer patients treated at nine institutions in Austria were collected in a centrally reviewed database. Included in this study were 383 patients with a negative sentinel node biopsy who were treated without axillary dissection. The median follow‐up was 19.5 months. 
Results: Sentinel node biopsy was performed using blue dye (21.2 %), radiocolloid (24 %) or the combination of both methods (54.8 %).Two axillary recurrences were observed. Both patients developed distant disease synchronously or metachronously. Primary tumours of both patients showed high nuclear grading and negative hormone receptor status. Tumour size at primary diagnosis was 12 mm and 22 mm, respectively. 
Conclusions: The current results of sentinel node biopsy seem to confirm the accuracy of the method. There are only sporadic reports in the literature on axillary recurrence after sentinel node biopsy. The risk of treatment failure after sentinel node biopsy can only be determined after the completion of prospective randomized trials. Therefore, sentinel node biopsy should be performed within therapeutic concepts with quality control.

Our experience shows SNB to be reliable and accurate for axillary staging in breast cancer patients. Morbidity after SNB alone was low. Conclusive data on the local recurrence rate are not yet available. Under certain conditions, SNB appears to have future clinical potential, even in patients with PC and MC, which must be confirmed in further multicentric studies. In the meantime, this method has attained definite value in the surgical therapy of breast cancer patients.

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91 Background: Due to improved screening for early breast cancer, the percentages of small and nonpalpable breast tumors have significantly increased during the last decades. After lumpectomy, re-excision rates of 32%-63% have been reported and the routine placement of localization needles is painful, time-consuming, and costly. In this study we investigated the value of intraoperative ultrasound (IOUS) in the hand of the breast surgeon as a fast and cheap method for potentially improving unacceptable re-excision rates. Methods: Between July 2001 and December 2010, in 773 of 1,195 breast cancer patients a breast-conserving treatment has been performed at the certified breast care center Vorarlberg (breast-conservation rate 64.7%). In 74.9% (579/773) of the tumors IOUS was performed, of which 44% were nonpalpable and 56% were insufficiently palpable, respectively. 7.5-10 MHz linear ultrasound probes were used by four breast surgeons in combination with intraoperative macroscopic resection margin assessment by the pathologist for prospective evaluation of definitive resection margin status over time. Furthermore, local recurrence rates were assessed. Results: During the study period, 579 of the included primary tumors were detected by IOUS. The metachronous re-excision rate was halved from 22% (30/135) in the period 2001-2003 to 11% (13/121) between 2008 and 2010. Between 2001 and 2010 we achieved a total re-excision rate of 13% (74/579). In 53% of re-excision specimens, no residual tumor was present, in 23% DCIS and in 24% invasive tumor was found, respectively. At a median follow-up of 56.4 months, a local recurrence rate of 1.7% was observed using our approach of IOUS combined with intraoperative margin assessment. Conclusions: IOUS in the hand of the breast surgeon proved to be a valuable, fast, and cheap method to improve metachronous re-excision rates in breast-conserving surgery. Patients can be spared the painful, costly, and time-consuming placement of a localization needle. Furthermore, tissue-sparing operations can be performed more easily and intraoperative specimen radiography can be avoided. The actual pathologic tumor size, however, is often being underestimated, especially regarding in situ cancers.