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Published in: Annals of Surgical Oncology 1/2005

01-01-2005 | Original Article

Beyond the Clinical Trials: How Often Is Sentinel Lymph Node Dissection Performed for Breast Cancer?

Authors: Melinda A. Maggard, MD, Karen E. Lane, MD, Jessica B. O’Connell, MD, Deepa Dharshani Nanyakkara, Clifford Y. Ko, MD, MSHS

Published in: Annals of Surgical Oncology | Issue 1/2005

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Abstract

Background

Sentinel lymph node dissection (SLND) has been shown to be a reasonable treatment option for early-stage breast cancer. Until recently, SLND was limited to clinical trials. Because this technique is now offered outside of trials, its prevalence is unknown.

Methods

All patients with stage I or II breast cancer in the Surveillance, Epidemiology, and End Results national cancer registry (1998–2000) were evaluated. Data were collected for demographics, tumor characteristics, surgical resection, lymph node evaluation (SLND or complete axillary dissection), registry site, and year of diagnosis. Multivariate regression analysis was performed to identify predictors for receiving SLND.

Results

A total of 54,772 patients diagnosed with breast cancer had undergone surgical lymph node evaluation; 27.2% patients with stage I disease underwent SLND, as compared with 22.7% for stage II. Older patients and minority groups were less likely to receive SLND. Receipt of SLND varied by registry site (7.9%–32.7%). Multivariate regression showed that older patients had lower odds of receiving SLND (60–69 years: odds ratio, .73; P < .0001) as compared with younger patients. Additionally, blacks, Hispanics, and Asians had lower odds of receiving SLND (odds ratio of .64, .58, and .80, respectively; P < .0001). SLND use increased over the 3 years in the study (P < .0001).

Conclusions

This population-based analysis showed relatively infrequent use of SLND for early-stage breast cancer. These results suggest a slow transition of this procedure from clinical trials into the community. Future work should be targeted at improving the rate at which patients receive this procedure, particularly for elderly and minority groups and low-use regions.
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Metadata
Title
Beyond the Clinical Trials: How Often Is Sentinel Lymph Node Dissection Performed for Breast Cancer?
Authors
Melinda A. Maggard, MD
Karen E. Lane, MD
Jessica B. O’Connell, MD
Deepa Dharshani Nanyakkara
Clifford Y. Ko, MD, MSHS
Publication date
01-01-2005
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1007/s10434-004-1168-y

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