Sentinel lymph node biopsy in breast cancer: Canadian practice patterns.
BACKGROUND
Recent data suggest sentinel lymph node biopsy (SLNBx) for invasive breast cancer (IBC) is widely performed in the United States, often outside of a clinical trial. We sought to describe SLNBx practice patterns in Canada, as well as criteria for abandonment of concurrent axillary lymph node dissection.


METHODS
All active (n = 1172) general surgeons in Canada were sent a 31-item questionnaire.


RESULTS
Of the 519 respondents who treated IBC, 138 (27%) performed SLNBx, whereas 378 (73%) did not. Surgeons who did not perform SLNBx most commonly cited a lack of adequate resources (64%). Of the 138 surgeons who performed SLNBx, 16% participated in one of the ongoing multicenter clinical trials. Of the 39 (28%) surgeons who abandoned routine concurrent axillary lymph node dissection, 20 (51%) performed <30 combined procedures before performing SLNBx alone. On multivariate analysis, surgical oncology training (P =.005), increasing proportion of practice devoted to breast disease (P <.001), and number of days per week in the operating room (P <.001) were associated with the use of SLNBx.


CONCLUSIONS
In contrast to the United States, SLNBx for IBC in Canada was not as common, and few surgeons participated in clinical trials. Fellowship-trained surgical oncologists and surgeons with a high exposure to breast disease seemed to be most involved in the development of SLNBx for IBC.
Porter
Geoffrey A
GA
Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. geoff.porter@dal.ca
McMulkin
Heather
H
Lovrics
Peter J
PJ
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D002170:Canada; D002986:Clinical Trials as Topic; D004501:Education, Medical; D019317:Evidence-Based Medicine; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data*