title: Assessing patterns of practice of sentinel lymph node biopsy for breast cancer in Latin America.
abstract: BACKGROUND
  There is a lack information regarding how sentinel lymph node biopsy (SLNB) for breast cancer is carried out today in developing countries and how it was adapted. To rectify this situation we performed a pattern-of-practice survey amongst practicing surgeons in Latin America (LA).
  
  
  METHODS
  A survey was developed to assess current surgical practice in breast cancer, use of SLNB, limitations to the implementation, training, technique variations, and observed adverse events. A total of 30 surgical associations and breast surgery societies in 18 Latin American countries were invited to participate. Surveys were distributed among member of these associations and 76.7 % of those contacted answered the survey. Responses were limited only to those who reported treating breast cancer patients.
  
  
  RESULTS
  A total of 463 surgeons who manage breast cancer responded. Over 53 % of surgeons do not have sub-specialty training. Only 47.7 % have a high-volume case load, of which 87.8 % routinely perform SLNB. The main limitations perceived to the implementation of SLNB were a lack of resources/equipment (48 %) and training opportunities (33 %). Over 60 % reported that fewer than half of their patients were eligible for SLNB and 67.8 % reported that they were involved in teaching this technique to residents.
  
  
  CONCLUSIONS
  A significant proportion of surgeons that treat breast cancer cases in LA have not had sub-specialty training or manage a low volume of cases. Among those surgeons with a high-volume caseload, SLNB is routinely performed. SLNB training during residency represents an opportunity for improvement in the region.
authors.affiliation: Department of Surgery, University of Toronto, Toronto, ON, Canada, sergio.acuna@utoronto.ca.
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Acuna
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Angarita
authors.forename: Jaime
authors.initials: J
authors.lastname: Escallon
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007843:Latin America; D008297:Male; D010818:Practice Patterns, Physicians'; D021701:Sentinel Lymph Node Biopsy; D013043:Specialties, Surgical; D011795:Surveys and Questionnaires