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Quality Indicators for Sentinel Lymph Node Biopsy in Breast Cancer: Applicability and Clinical Relevance in a Non-screened Population

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Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Quality Indicators for Sentinel Lymph Node Biopsy in Breast Cancer: Applicability and Clinical Relevance in a Non-screened Population: sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) as standard of care for management of early breast cancer. This study assessed our SLNB program against 11 published quality indicators (QIs). All breast cancer patients who underwent SLNB in our centre from June 2013–Dec 2015 were included. Clinical, pathological and follow-up data were extracted from the institutional REDCap data system. Analysis was done with SPSS 23. Following validation, 234 patients had SLNB, always performed along with primary surgery. Identification rate was 95.3% and > 1 SLN was identified in 72% of patients. SLNB positivity was 33%, of these, 100% underwent ALND. Overall 91% of QI eligible patients underwent SLNB. No ineligible patients (T4) underwent SLNB. For the patients who had radio colloid, injection criteria were met for 100%. Pathological evaluation and reporting criteria were met for 100% of patients. There were no axillary recurrences in a median follow-up of 2 years. 7.6% patients had SLN negative on frozen section but positive on final histology. 7.2% of patients with clinical negative nodes had pN2 disease in final histopathology report after surgery. Sixty percent of patients who had completion ALND had only positive SLN. This study supports the applicability of published QI of SLNB in a non-screened cohort of early breast cancer patients. Although QI were useful, modification based on patient characteristics and resource availability may be needed. These indicators can be used as audit tools to improve the overall accuracy of the procedure.

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Authors and Affiliations

  1. Department of Breast Oncosurgery, Tata Medical Center, Kolkata, India

    Sanjit Kumar Agrawal, Sachin Suresh Shenoy, Nikhil Nalawade & Rosina Ahmed

  2. Department of Palliative Care and Psycho-oncology, Tata Medical Center, Kolkata, India

    Soumtira Shankar Datta

  3. Department of Nuclear Medicine, Tata Medical Center, Kolkata, India

    Soumendranath Roy

  4. Department of Clinical Oncology, Tata Medical Center, Kolkata, India

    Sanjoy Chatterjee

  5. Department of Pathology, Tata Medical Center, Kolkata, India

    Indu Arun

Authors
  1. Sanjit Kumar Agrawal
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  2. Sachin Suresh Shenoy
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Correspondence to Sanjit Kumar Agrawal.

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Agrawal, S.K., Shenoy, S.S., Nalawade, N. et al. Quality Indicators for Sentinel Lymph Node Biopsy in Breast Cancer: Applicability and Clinical Relevance in a Non-screened Population. Indian J Surg Oncol 9, 312–317 (2018). https://doi.org/10.1007/s13193-017-0695-5

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  • DOI: https://doi.org/10.1007/s13193-017-0695-5

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