Geographic variation in sentinel node adaptation by practicing surgeons in Oregon

The sentinel node biopsy (SNB) technique is an important tool in the diagnosis and treatment of breast cancer and melanoma. However, surgeons in Oregon have not universally adopted its use. Mailed questionnaire. The response rate was 32%. Seventy-four (76%) of the surgical respondents perform routin...

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Bibliographic Details
Published in:The American journal of surgery 2005-05, Vol.189 (5), p.616-620
Main Authors: Garreau, Jennifer R., Nelson, Joanne, Cook, David, Vetto, John, Walts, Deb, Homer, Louis, Johnson, Nathalie
Format: Article
Language:English
Subjects:
Axillary node dissection
Biopsy
Breast cancer
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Clinical Competence
Clinical trials
Dissection
Geography
Hospitals
Humans
Learning curve
Lymphatic Metastasis - pathology
Lymphatic system
Melanoma
Melanoma - pathology
Melanoma - surgery
Oregon
Practice Patterns, Physicians' - statistics & numerical data
Questionnaires
Reporting requirements
Response rates
Rural health care
Sentinel Lymph Node Biopsy
Sentinel node biopsy
Surveys and Questionnaires
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Summary:The sentinel node biopsy (SNB) technique is an important tool in the diagnosis and treatment of breast cancer and melanoma. However, surgeons in Oregon have not universally adopted its use. Mailed questionnaire. The response rate was 32%. Seventy-four (76%) of the surgical respondents perform routine SNB; 49% completed courses, and 32% learned the technique in residency. Sixty-one (89%) performed axillary dissection with their initial cases. It took 21 of 40 (52%) surgeons greater than a year to accrue 20 cases. Of 23 surgeons (24%) not performing SNB, 89% believed it was an important skill to obtain, and 70% thought they would benefit from proctoring opportunities. Six (26%) did not have technological support at their hospital. Surgeons at hospitals with less than 50 beds ( P = .001) and at rural hospitals ( P = .003) were less likely to perform SNB. The majority of urban general surgeons in Oregon use SNB in their practice. However, the incorporation of SNB for surgeons practicing in smaller hospitals and rural settings is less frequent than in the urban environment. As SNB becomes the standard of care, we need to overcome these barriers so that patients can have access to this procedure in their own communities.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2005.01.039