Improvement in sentinel node biopsy results in a teaching community hospital: results of a multidisciplinary quality improvement program.
BACKGROUND
In 2001 we reported poor results for sentinel node biopsy and marked variability among surgeons. Subsequently, we initiated a multidisciplinary protocol involving standardized radiocolloid injection, physician education, and surgeon proctoring.


METHODS
The current study presents follow-up data (2004-2006) after this quality improvement initiative. Data recorded included technical details and patient factors, related to each surgeon. Results were compared with our previously published data.


RESULTS
The overall identification rate was improved markedly from 2001 (92% vs 66%). Eleven general surgeons performed 151 sentinel node biopsies. Seven surgeons had a 100% identification rate, the others had identification rates of 84% (N = 44), 86% (N = 29), 92% (N = 12), and 0% (N = 1). Differences still persist among surgeons, including number of sentinel nodes sampled, performance of axillary dissections, and breast conservation.


CONCLUSIONS
A multidisciplinary protocol improved sentinel node biopsy performance in a community teaching hospital. However, further work is needed to standardize and improve overall breast surgery results.
Orr
Richard K
RK
Division of Surgical Oncology, Spartanburg Regional Medical Center, 101 E. Wood St., Spartanburg, SC 29303, USA. rick1841@yahoo.com
Wheeler
Kerry L
KL
Barrineau
Devonne D
DD
Hird
R Barry
RB
D001943:Breast Neoplasms / Q000473:pathology*; D002983:Clinical Competence; D005260:Female; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D011785:Quality Assurance, Health Care; D021701:Sentinel Lymph Node Biopsy / Q000592:standards*