OBJECTIVE: To determine the success rate of sentinel node dissection and the sensitivity of sentinel node to determine the presence of axillary node metastasis in women with clinically node negative breast cancer. DESIGN: Case series. PLACE AND DURATION OF STUDY: The study was conducted at Department of General Surgery Pakistan Institute of Medical Sciences, Islamabad (PIMS) and Nuclear Oncology and Radiotherapy Institute, Islamabad (NORI) from January 2002 to December 2003. PATIENTS AND METHODS: A total of 15 patients of early carcinoma breast were recruited in the study. Five patients were injected with radiocolloid and later with isosulfan blue in the subareolar region. Ten patients were given isosulfan blue only. All the patients were subjected to standard axillary clearance after sentinel node biopsy through separate incisions. Sentinel node was examined by intra-operative frozen section and all of the dissected lymph nodes were examined histopathologically for tumour deposits. RESULTS: Sentinel lymph node was successfully excised in all the cases 15/15 (100%). In 14 of the patients the sentinel node pathology was truly predictive of axillary nodal status. Sensitivity of the test was 93.33% and the positive predictive value was 100%. CONCLUSION: Sentinel node biopsy should be followed by standard axillary lymph adenectomy until the results of multiple prospective randomized trials define the role of this technique in the management of carcinoma breast.