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.
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.
Authors: Sandra A Norman; A Russell Localio; Michael J Kallan; Anita L Weber; Heather A Simoes Torpey; Sheryl L Potashnik; Linda T Miller; Kevin R Fox; Angela DeMichele; Lawrence J Solin Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-10-26 Impact factor: 4.254
Authors: William R Carpenter; Katherine Reeder-Hayes; John Bainbridge; Anne-Marie Meyer; Keith D Amos; Bryan J Weiner; Paul A Godley Journal: Med Care Date: 2011-02 Impact factor: 2.983
Authors: Katherine E Reeder-Hayes; John Bainbridge; Anne Marie Meyer; Keith D Amos; Bryan J Weiner; Paul A Godley; William R Carpenter Journal: Breast Cancer Res Treat Date: 2011-02-22 Impact factor: 4.872
Authors: Igor Langer; Ulrich Guller; Gilles Berclaz; Ossi R Koechli; Gabriel Schaer; Mathias K Fehr; Thomas Hess; Daniel Oertli; Lucio Bronz; Beate Schnarwyler; Edward Wight; Urs Uehlinger; Eduard Infanger; Daniel Burger; Markus Zuber Journal: Ann Surg Date: 2007-03 Impact factor: 12.969
Authors: Ellen P McCarthy; Long H Ngo; Richard G Roetzheim; Thomas N Chirikos; Donglin Li; Reed E Drews; Lisa I Iezzoni Journal: Ann Intern Med Date: 2006-11-07 Impact factor: 25.391