title: A concept for the clinical implementation of sentinel lymph node biopsy in patients with breast carcinoma with special regard to quality assurance.
abstract: The development of standardized and reproducible clinical pathways is an important precondition for quality assurance in medicine, especially if a new method has not yet been ultimately validated. Sentinel lymph node biopsy (SLNB) is a widely accepted new surgical procedure in the treatment of early breast carcinoma. However, numerous steps of the method and details of the technique are not standardized and, thus, hamper quality assurance for SLNB. The German Society of Senology appointed an interdisciplinary consensus committee to work out guidelines for the standardized performance and quality-assured implementation of SLNB on a nationwide, homogeneous standard. The committee consisted of surgeons, gynecologists, radiooncologists, nuclear physicians, oncologists, and pathologists. Relevant questions related to patient selection, lymphatic mapping, surgery, histopathologic work-up, further local and systemic treatment decisions, patient information, training, and follow-up were evaluated with respect to clinical evidence, objectivity, and reproducibility. Clinical pathways were developed on the basis of this analysis. Requirements to the performing institutions and surgeons were defined.
authors.affiliation: Department of Gynecology and Obstetrics, Interdisciplinary Breast Center, Gifhorn, Germany. kuehn.thorston@t-online.de
authors.forename: Thorsten
authors.initials: T
authors.lastname: Kuehn
authors.forename: Andreas
authors.initials: A
authors.lastname: Bembenek
authors.forename: Thomas
authors.initials: T
authors.lastname: Decker
authors.forename: Dieter Ludwig
authors.initials: DL
authors.lastname: Munz
authors.forename: Marie-Luise
authors.initials: ML
authors.lastname: Sautter-Bihl
authors.forename: Michael
authors.initials: M
authors.lastname: Untch
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D003245:Consensus Statements as Topic; D005260:Female; D005858:Germany; D006801:Humans; D011785:Quality Assurance, Health Care; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods* / Q000592:standards*; D012955:Societies, Medical
chemical_list: D019275:Radiopharmaceuticals