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Assessing Patterns of Practice of Sentinel Lymph Node Biopsy for Breast Cancer in Latin America

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Abstract

Introduction

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.

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Acknowledgments

This project was financed by The Marvelle Koffler Breast Centre, Mount Sinai Hospital, Toronto, Canada.

Conflict of interest

The authors declare no conflicts of interest.

Author information

Author notes

  1. Sergio A. Acuna

    Present address: Institute of Health Policy, Management and Education, University of Toronto, Toronto, ON, Canada

  2. Fernando A. Angarita

    Present address: Toronto General Research Institute, University Health Network, Toronto, ON, Canada

Authors and Affiliations

  1. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Sergio A. Acuna, Fernando A. Angarita & Jaime Escallon

  2. Department of Surgery, Marvelle Koffler Breast Centre, Mount Sinai Hospital, Room 1266, 600 University Avenue, Toronto, ON, M5G 1X5, Canada

    Jaime Escallon

Authors
  1. Sergio A. Acuna
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  2. Fernando A. Angarita
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Corresponding author

Correspondence to Jaime Escallon.

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Acuna, S.A., Angarita, F.A. & Escallon, J. Assessing Patterns of Practice of Sentinel Lymph Node Biopsy for Breast Cancer in Latin America. World J Surg 38, 1077–1083 (2014). https://doi.org/10.1007/s00268-013-2382-1

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