Surgeon and community factors affecting breast cancer sentinel lymph node biopsy.
BACKGROUND
We sought to determine whether the results of sentinel lymph node (SLN) biopsy are related to practice and community factors.


METHODS
This prospective study included more than 300 surgeons from a variety of practice environments. Most surgeons had minimal experience with SLN biopsy prior to this study. Patients underwent attempted SLN biopsy, followed by completion axillary dissection. Univariate and multivariate analyses were performed to assess factors related to the SLN identification rate and the false negative rate.


RESULTS
A total of 4131 patients were enrolled. SLN identification rate was 93%; the false negative (FN) rate was 7.9%. The only factor that was significantly associated with improved SLN identification rate (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.12 to 2.36, P = .0126) and FN rate (OR 2.39, 95% CI 1.32 to 4.79, P = .0073) was surgeon experience (>20 SLN cases).


CONCLUSIONS
Surgeon experience is the major factor that contributes to improved SLN biopsy results. SLN biopsy can be performed equally well by community and academic surgeons.
Hutchinson
Julie R
JR
Division of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, KY 40292, USA.
Chagpar
Anees B
AB
Scoggins
Charles R
CR
Martin
Robert C G
RC
Carlson
David J
DJ
Laidley
Alison L
AL
El-Eid
Souzan E
SE
McGlothin
Terre Q
TQ
Noyes
Robert D
RD
Ley
Phillip B
PB
Tuttle
Todd M
TM
McMasters
Kelly M
KM
D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D010819:Physician's Role; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012111:Residence Characteristics; D021701:Sentinel Lymph Node Biopsy; D014481:United States