Objective: This study aims to evaluate the effectiveness of sentinel lymph node biopsy (SLNB) in early-stage breast cancer for predicting axillary lymph node staging among female athletes, examining the efficacy of the blue-staining technique versus a combined method for SLN detection, and assessing how clinical characteristics influence SLN detection rates, with an emphasis on the physical fitness of female athletes. Methods: We conducted a retrospective analysis of 190 female athletes who underwent SLNB at the Department of Breast Surgery, Affiliated Cancer Hospital of our University. Of these, 134 were subjected to a combined radionuclide and melanin staining tracer method for SLN localization, while 56 received a melanin dye injection method. Subsequent actions, including axillary lymph node dissection (ALND), were determined based on SLN results and patient preferences for "axillary preservation.". Results: SLNB successfully identified SLNs in 188 out of 190 athletes, yielding a detection rate of 98.9%, an accuracy rate of 94.6%, and a false-negative rate of 11.6%. The study highlighted the influence of age on detection and false-negative rates, recommending the combined method for athletes aged ≥50 years. Notably, lesion location, size, nuclei injection site, and pathological type showed no significant impact on detection or false-negative rates. Conclusion: SLNB serves as a reliable predictor of axillary lymph node status in female athletes with early breast cancer, offering precise SLN localization through both blue-staining and combined methods. The study underscores the importance of age in determining the most effective detection method, while also suggesting that physical fitness levels do not significantly alter the outcomes of SLN detection rates. This insight into SLNB efficacy, tailored to the specific needs and characteristics of female athletes, paves the way for more personalized and fitness-conscious approaches to breast cancer staging and treatment.