Number of nodes in sentinel lymph node biopsy for breast cancer: Are surgeons still biased?

Background and Objectives The purpose of this study was to assess the number of lymph nodes removed at SLNB, and what factors might bias a surgeon's decision to remove additional nodes. Methods A prospectively maintained database was reviewed. All patients that had SLNB for primary treatment of...

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Published in:Journal of surgical oncology 2018-06, Vol.117 (7), p.1487-1492
Main Authors: Percy, Dean B., Pao, Jin‐Si, McKevitt, Elaine, Dingee, Carol, Kuusk, Urve, Warburton, Rebecca
Format: Article
Language:English
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axilla
Biopsy
Breast cancer
Cancer surgery
Lymphatic system
sentinel lymph node biopsy
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cited_by cdi_FETCH-LOGICAL-c3530-5e931f6a6cbcae2ce1f99459d113a3ca893b2143a0ae83538e4ded33981d6baa3
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container_issue 7
container_start_page 1487
container_title Journal of surgical oncology
container_volume 117
creator Percy, Dean B.
Pao, Jin‐Si
McKevitt, Elaine
Dingee, Carol
Kuusk, Urve
Warburton, Rebecca
description Background and Objectives The purpose of this study was to assess the number of lymph nodes removed at SLNB, and what factors might bias a surgeon's decision to remove additional nodes. Methods A prospectively maintained database was reviewed. All patients that had SLNB for primary treatment of breast cancer between January 2012 and March 2016 were identified. Clinicopathologic factors were used to compare the number of LNs and rates of node positivity. Results One thousand six hundred and three patients were included. The average number of SLNs, non‐SLNs, and total LNs was 2.53, 0.54, 3.08, respectively. Significantly more LNs were removed in age 40 (3.73, 3.04 P 
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Methods A prospectively maintained database was reviewed. All patients that had SLNB for primary treatment of breast cancer between January 2012 and March 2016 were identified. Clinicopathologic factors were used to compare the number of LNs and rates of node positivity. Results One thousand six hundred and three patients were included. The average number of SLNs, non‐SLNs, and total LNs was 2.53, 0.54, 3.08, respectively. Significantly more LNs were removed in age <40 versus age >40 (3.73, 3.04 P < 0.01), invasive versus DCIS (3.13, 2.73 P < 0.001), Grade III versus Grade II (3.42, 2.99 P < 0.01), T2 versus T1 (3.40, 2.96 P < 0.01), and ER‐ versus ER+ (3.45, 3.05 P < 0.05). SLN positivity was significantly higher (P < 0.05) in invasive versus DCIS (27%, 4%), T2 versus T1 (30%. 17%), Grade II versus Grade I (42%, 18%), and ILC versus IDC (38%, 26%). Conclusions There was a significant difference in the number of lymph nodes removed at SLNB in certain groups however; node positivity was not necessarily higher in these groups. Surgeons must be cognizant of potential bias when performing SLNB.]]></description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.25010</identifier><identifier>PMID: 29484663</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>axilla ; Biopsy ; Breast cancer ; Cancer surgery ; Lymphatic system ; sentinel lymph node biopsy</subject><ispartof>Journal of surgical oncology, 2018-06, Vol.117 (7), p.1487-1492</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3530-5e931f6a6cbcae2ce1f99459d113a3ca893b2143a0ae83538e4ded33981d6baa3</citedby><cites>FETCH-LOGICAL-c3530-5e931f6a6cbcae2ce1f99459d113a3ca893b2143a0ae83538e4ded33981d6baa3</cites><orcidid>0000-0001-9377-2269</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29484663$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Percy, Dean B.</creatorcontrib><creatorcontrib>Pao, Jin‐Si</creatorcontrib><creatorcontrib>McKevitt, Elaine</creatorcontrib><creatorcontrib>Dingee, Carol</creatorcontrib><creatorcontrib>Kuusk, Urve</creatorcontrib><creatorcontrib>Warburton, Rebecca</creatorcontrib><title>Number of nodes in sentinel lymph node biopsy for breast cancer: Are surgeons still biased?</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description><![CDATA[Background and Objectives The purpose of this study was to assess the number of lymph nodes removed at SLNB, and what factors might bias a surgeon's decision to remove additional nodes. Methods A prospectively maintained database was reviewed. All patients that had SLNB for primary treatment of breast cancer between January 2012 and March 2016 were identified. Clinicopathologic factors were used to compare the number of LNs and rates of node positivity. Results One thousand six hundred and three patients were included. The average number of SLNs, non‐SLNs, and total LNs was 2.53, 0.54, 3.08, respectively. Significantly more LNs were removed in age <40 versus age >40 (3.73, 3.04 P < 0.01), invasive versus DCIS (3.13, 2.73 P < 0.001), Grade III versus Grade II (3.42, 2.99 P < 0.01), T2 versus T1 (3.40, 2.96 P < 0.01), and ER‐ versus ER+ (3.45, 3.05 P < 0.05). SLN positivity was significantly higher (P < 0.05) in invasive versus DCIS (27%, 4%), T2 versus T1 (30%. 17%), Grade II versus Grade I (42%, 18%), and ILC versus IDC (38%, 26%). Conclusions There was a significant difference in the number of lymph nodes removed at SLNB in certain groups however; node positivity was not necessarily higher in these groups. Surgeons must be cognizant of potential bias when performing SLNB.]]></description><subject>axilla</subject><subject>Biopsy</subject><subject>Breast cancer</subject><subject>Cancer surgery</subject><subject>Lymphatic system</subject><subject>sentinel lymph node biopsy</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp10E1LxDAQBuAgiq4fB_-ABLzooTppujXjRUT8RPSgnjyUNJ1ql7ZZM1tk_73RVQ-Cp8DkmZfhFWJbwYECSA8n7A_SMShYEiMFmCcIaJbFKP6lSXaEsCbWmScAgJhnq2Itxcxkea5H4vlu6EoK0tey9xWxbHrJ1M-anlrZzrvp69dclo2f8lzWPsgykOWZdLZ3FI7laSDJQ3gh37PkWdO2EVum6mRTrNS2Zdr6fjfE08X549lVcnt_eX12eps4PdaQjAm1qnObu9JZSh2pGjEbY6WUttpZg7pMVaYtWDJxw1BWUaU1GlXlpbV6Q-wtcqfBvw3Es6Jr2FHb2p78wEUKYIxBxKNId__QiR9CH6-LKk9RGUAd1f5CueCZA9XFNDSdDfNCQfHZeBEbL74aj3bnO3EoO6p-5U_FERwuwHvT0vz_pOLm4X4R-QFZwYnU</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Percy, Dean B.</creator><creator>Pao, Jin‐Si</creator><creator>McKevitt, Elaine</creator><creator>Dingee, Carol</creator><creator>Kuusk, Urve</creator><creator>Warburton, Rebecca</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9377-2269</orcidid></search><sort><creationdate>20180601</creationdate><title>Number of nodes in sentinel lymph node biopsy for breast cancer: Are surgeons still biased?</title><author>Percy, Dean B. ; Pao, Jin‐Si ; McKevitt, Elaine ; Dingee, Carol ; Kuusk, Urve ; Warburton, Rebecca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3530-5e931f6a6cbcae2ce1f99459d113a3ca893b2143a0ae83538e4ded33981d6baa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>axilla</topic><topic>Biopsy</topic><topic>Breast cancer</topic><topic>Cancer surgery</topic><topic>Lymphatic system</topic><topic>sentinel lymph node biopsy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Percy, Dean B.</creatorcontrib><creatorcontrib>Pao, Jin‐Si</creatorcontrib><creatorcontrib>McKevitt, Elaine</creatorcontrib><creatorcontrib>Dingee, Carol</creatorcontrib><creatorcontrib>Kuusk, Urve</creatorcontrib><creatorcontrib>Warburton, Rebecca</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Percy, Dean B.</au><au>Pao, Jin‐Si</au><au>McKevitt, Elaine</au><au>Dingee, Carol</au><au>Kuusk, Urve</au><au>Warburton, Rebecca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Number of nodes in sentinel lymph node biopsy for breast cancer: Are surgeons still biased?</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>117</volume><issue>7</issue><spage>1487</spage><epage>1492</epage><pages>1487-1492</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract><![CDATA[Background and Objectives The purpose of this study was to assess the number of lymph nodes removed at SLNB, and what factors might bias a surgeon's decision to remove additional nodes. Methods A prospectively maintained database was reviewed. All patients that had SLNB for primary treatment of breast cancer between January 2012 and March 2016 were identified. Clinicopathologic factors were used to compare the number of LNs and rates of node positivity. Results One thousand six hundred and three patients were included. The average number of SLNs, non‐SLNs, and total LNs was 2.53, 0.54, 3.08, respectively. Significantly more LNs were removed in age <40 versus age >40 (3.73, 3.04 P < 0.01), invasive versus DCIS (3.13, 2.73 P < 0.001), Grade III versus Grade II (3.42, 2.99 P < 0.01), T2 versus T1 (3.40, 2.96 P < 0.01), and ER‐ versus ER+ (3.45, 3.05 P < 0.05). SLN positivity was significantly higher (P < 0.05) in invasive versus DCIS (27%, 4%), T2 versus T1 (30%. 17%), Grade II versus Grade I (42%, 18%), and ILC versus IDC (38%, 26%). Conclusions There was a significant difference in the number of lymph nodes removed at SLNB in certain groups however; node positivity was not necessarily higher in these groups. Surgeons must be cognizant of potential bias when performing SLNB.]]></abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29484663</pmid><doi>10.1002/jso.25010</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-9377-2269</orcidid></addata></record>
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subjects axilla
Biopsy
Breast cancer
Cancer surgery
Lymphatic system
sentinel lymph node biopsy
title Number of nodes in sentinel lymph node biopsy for breast cancer: Are surgeons still biased?
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