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Published on: August 19, 2021
Quality indicators for sentinel lymph node biopsy: is there room for improvement?
Sergio A Acuna1, Fernando A Angarita, David R McCready
1The Department of Surgery, University of Toronto, Toronto General Research Institute, Toronto, Ont.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|January 29, 2013
Summary
Quality indicators (QIs) for sentinel lymph node biopsy (SLNB) are feasible for surgeons but require modifications. Protocol-based QIs should be prerequisites, while surgical QIs need routine measurement and defined target rates.
Area of Science:
- Oncology
- Surgical Oncology
- Pathology
Background:
- Eleven quality indicators (QIs) for sentinel lymph node biopsy (SLNB) were established via consensus but lack clinical integration.
- Surgeon applicability and clinical relevance of these QIs require evaluation.
Purpose of the Study:
- To assess the feasibility and clinical relevance of 11 quality indicators (QIs) for sentinel lymph node biopsy (SLNB) in surgical practice.
- To refine the application of QIs for quality assessment in SLNB procedures.
Main Methods:
- Retrospective review of 300 breast cancer patients undergoing SLNB between 2004-2008.
- Evaluation of adherence to standardized protocols, including radiocolloid injection and pathology.
- Analysis of clinical, pathological, and axillary recurrence data.
Main Results:
- All 11 QIs were measurable in 300 patients; 100% identification rate for SLNs.
- High compliance with protocols for radiocolloid injection and pathology; no ineligible patients underwent SLNB.
- Low axillary recurrence rate (1/42) with 5-year follow-up.
Conclusions:
- Implementation of QIs for SLNB is feasible but necessitates modifications for practicality.
- Protocol-based QIs (nuclear medicine, pathology) should be prerequisites, distinct from surgical QIs.
- Surgical QIs require routine measurement by surgeons, with defined target rates for standardization.
