Implementation of sentinel node biopsy for breast cancer in a community hospital

Eli Avisar, Lena Shekhtman

Research output: Contribution to journalArticle

Abstract

Institutional learning curves for performance of sentinel node biopsy (SNB) have previously been studied, but no distinction has been possible between surgical and institutional curves. The goal of this study was to assess the specific institutional learning curve for SNB in a community hospital implementing this technique. Upon implementation of SNB in a community hospital, backup axillary dissection was performed. The surgeon had extensive experience prior to the study. The SNB was performed with technetium sulfur colloid injected within 24 hours and Patent Blue dye injected within 30 minutes of the skin incision. Two learning curves were derived: one depicting identification failures in relation to the cumulative number of procedures performed by the community hospital team and one showing the false-negative rate in relation to the total number of cases with nodal metastasis. Fifty-nine patients were enrolled in this study. Sentinel node(s) were identified in 57 patients (96.6%), yielding an overall failure rate of 3.4%. In this study, no specific institutional learning curve was identified for SNB. In a well-controlled and carefully designed implementation process, an experienced surgeon can build a new collaborative team for SNB and can rapidly achieve very good results.

Original languageEnglish
JournalCommunity Oncology
Volume5
Issue number5
StatePublished - May 1 2008

Fingerprint

Community Hospital
Breast Neoplasms
Learning Curve
Biopsy
Technetium Tc 99m Sulfur Colloid
cyhalothrin
Dissection
Coloring Agents
Neoplasm Metastasis
Skin

ASJC Scopus subject areas

  • Oncology

Cite this

Implementation of sentinel node biopsy for breast cancer in a community hospital. / Avisar, Eli; Shekhtman, Lena.

In: Community Oncology, Vol. 5, No. 5, 01.05.2008.

Research output: Contribution to journalArticle

@article{b9bbafc77f534f9aa91081d031478987,
title = "Implementation of sentinel node biopsy for breast cancer in a community hospital",
abstract = "Institutional learning curves for performance of sentinel node biopsy (SNB) have previously been studied, but no distinction has been possible between surgical and institutional curves. The goal of this study was to assess the specific institutional learning curve for SNB in a community hospital implementing this technique. Upon implementation of SNB in a community hospital, backup axillary dissection was performed. The surgeon had extensive experience prior to the study. The SNB was performed with technetium sulfur colloid injected within 24 hours and Patent Blue dye injected within 30 minutes of the skin incision. Two learning curves were derived: one depicting identification failures in relation to the cumulative number of procedures performed by the community hospital team and one showing the false-negative rate in relation to the total number of cases with nodal metastasis. Fifty-nine patients were enrolled in this study. Sentinel node(s) were identified in 57 patients (96.6{\%}), yielding an overall failure rate of 3.4{\%}. In this study, no specific institutional learning curve was identified for SNB. In a well-controlled and carefully designed implementation process, an experienced surgeon can build a new collaborative team for SNB and can rapidly achieve very good results.",
author = "Eli Avisar and Lena Shekhtman",
year = "2008",
month = "5",
day = "1",
language = "English",
volume = "5",
journal = "Community Oncology",
issn = "1548-5315",
publisher = "BioLink Communications",
number = "5",

}

TY - JOUR

T1 - Implementation of sentinel node biopsy for breast cancer in a community hospital

AU - Avisar, Eli

AU - Shekhtman, Lena

PY - 2008/5/1

Y1 - 2008/5/1

N2 - Institutional learning curves for performance of sentinel node biopsy (SNB) have previously been studied, but no distinction has been possible between surgical and institutional curves. The goal of this study was to assess the specific institutional learning curve for SNB in a community hospital implementing this technique. Upon implementation of SNB in a community hospital, backup axillary dissection was performed. The surgeon had extensive experience prior to the study. The SNB was performed with technetium sulfur colloid injected within 24 hours and Patent Blue dye injected within 30 minutes of the skin incision. Two learning curves were derived: one depicting identification failures in relation to the cumulative number of procedures performed by the community hospital team and one showing the false-negative rate in relation to the total number of cases with nodal metastasis. Fifty-nine patients were enrolled in this study. Sentinel node(s) were identified in 57 patients (96.6%), yielding an overall failure rate of 3.4%. In this study, no specific institutional learning curve was identified for SNB. In a well-controlled and carefully designed implementation process, an experienced surgeon can build a new collaborative team for SNB and can rapidly achieve very good results.

AB - Institutional learning curves for performance of sentinel node biopsy (SNB) have previously been studied, but no distinction has been possible between surgical and institutional curves. The goal of this study was to assess the specific institutional learning curve for SNB in a community hospital implementing this technique. Upon implementation of SNB in a community hospital, backup axillary dissection was performed. The surgeon had extensive experience prior to the study. The SNB was performed with technetium sulfur colloid injected within 24 hours and Patent Blue dye injected within 30 minutes of the skin incision. Two learning curves were derived: one depicting identification failures in relation to the cumulative number of procedures performed by the community hospital team and one showing the false-negative rate in relation to the total number of cases with nodal metastasis. Fifty-nine patients were enrolled in this study. Sentinel node(s) were identified in 57 patients (96.6%), yielding an overall failure rate of 3.4%. In this study, no specific institutional learning curve was identified for SNB. In a well-controlled and carefully designed implementation process, an experienced surgeon can build a new collaborative team for SNB and can rapidly achieve very good results.

UR - http://www.scopus.com/inward/record.url?scp=44849088495&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44849088495&partnerID=8YFLogxK

M3 - Article

VL - 5

JO - Community Oncology

JF - Community Oncology

SN - 1548-5315

IS - 5

ER -