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Surgeon bias in sentinel lymph node dissection: Do tumor characteristics influence decision making?
Kristin A Robinson1, Barbara A Pockaj1, Nabil Wasif1
1Division of Surgical Oncology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, United States.
Breast (Edinburgh, Scotland)
|September 2, 2014
Summary
Patient and tumor characteristics impact the number of sentinel lymph nodes (SLNs) removed during breast cancer staging. Younger patients and those with higher grade tumors had more SLNs removed.
Area of Science:
- Oncology
- Surgical Pathology
- Biostatistics
Background:
- Sentinel lymph node (SLN) biopsy is crucial for breast cancer staging.
- Current SLN determination relies on surgeon interpretation, introducing variability.
Purpose of the Study:
- To investigate the influence of patient and tumor characteristics on the number of SLNs harvested.
- To identify factors affecting SLN count variability in breast cancer staging.
Main Methods:
- Analysis of a prospectively collected database of 2394 breast cancer patients undergoing SLN surgery (2002-2013).
- Comparison of mean SLN counts based on patient age, tumor size, tumor grade, and neoadjuvant therapy receipt.
Main Results:
- The mean number of SLNs removed was 2.6 per patient.
- Younger patients (≤50 years), higher grade tumors (2-3), and neoadjuvant therapy receipt were associated with more SLNs removed.
- Smaller tumors (≤1 cm) were associated with fewer SLNs removed.
Conclusions:
- The number of SLNs removed is influenced by patient and tumor factors.
- These factors may relate to the risk of SLN metastasis or false-negative biopsy results.
- Understanding these variables can optimize SLN biopsy interpretation and breast cancer staging.
