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Published on: June 1, 2019
Differential receipt of sentinel lymph node biopsy within practice-based research networks
Anne-Marie Meyer1, Katherine E Reeder-Hayes, Huan Liu
1Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7293, USA. annemarie.meyer@unc.edu
Medical Care
|August 15, 2013
Summary
Community Clinical Oncology Program (CCOP) affiliation accelerated sentinel lymph node biopsy (SLNB) adoption in breast cancer care. CCOP-affiliated physicians increased SLNB use, demonstrating PBRN effectiveness in practice integration.
Area of Science:
- Oncology
- Surgical Innovation
- Health Services Research
Background:
- Practice-based research networks (PBRNs) facilitate research dissemination into clinical practice.
- Sentinel lymph node biopsy (SLNB) offers reduced morbidity compared to standard axillary lymph node dissection for breast cancer.
- The Community Clinical Oncology Program (CCOP) is a cancer-focused PBRN.
Purpose of the Study:
- To examine the adoption rate of SLNB in breast cancer treatment.
- To determine if affiliation with the CCOP PBRN influenced the uptake of SLNB.
Main Methods:
- Analysis of Surveillance Epidemiology and End Results-Medicare data (2000-2005) for women with stage I/II breast cancer undergoing breast-conserving surgery.
- Ascertainment of CCOP affiliation for surgical physicians.
- Multivariable generalized linear modeling to assess the association between CCOP exposure and SLNB utilization.
Main Results:
- Women treated by CCOP-affiliated physicians showed significantly higher odds of undergoing SLNB (OR 2.68).
- This association exceeded the impact of treatment at medical school-affiliated hospitals (OR 1.76).
Conclusions:
- CCOP-affiliated physicians were more likely to perform SLNB, regardless of hospital affiliation.
- The CCOP PBRN appears to facilitate the rapid adoption of evidence-based innovations in community oncology practice.