AIMS: The goals of this paper were to determine the accuracy of the sentinel node in predicting axillary nodal status and to evaluate the feasibility of incorporating sentinel node biopsy into a general practice. METHODS: Between June 1999 and February 2003, 304 patients with clinically T0-T2[< 3 cm] M0 breast cancer underwent sentinel node biopsy. Both lymphoscintigraphy and blue dye were used to guide this biopsy. The procedure was followed by a complete axillary dissection in the first patients and when the sentinel node was positive. Sentinel nodes were evaluated using serial levels of hematoxylin eosin staining, and cytokeratin immunohistochemistry. RESULTS: The overall sentinel node detection rate was 99% (301 of 304 patients). The accuracy of the identification in operating room was 98% (296 of 301 patients). The sentinel node was involved in 75 patients (25%): metastases (38 patients), micrometastases (32 patients) and isolated tumor cells (5 patients). The false negative rate was 0% and the negative predictive value 100%. CONCLUSION: Our results support that the sentinel node biopsy is an accurate predictor of axillary nodal status in patients with early breast cancer and implementing a network greatly facilitates its' discovery.