Related Experiment Video
Updated: Jan 21, 2026
Dissection and 2-Photon Imaging of Peripheral Lymph Nodes in Mice
Published on: August 23, 2007
Decreasing rates of axillary lymph node dissections over time: Implications for surgical resident exposure and
Laura H Rosenberger1, Samantha M Thomas2, Jennifer K Plichta1
1Department of Surgery, Duke University Medical Center, Durham, NC, USA; Duke Cancer Institute, Duke University, Durham, NC, USA.
Background:
Sentinel lymph node biopsy has supplanted axillary lymph node dissection (ALND) in clinically node-negative breast cancer and select node-positive disease. We hypothesized a decreasing rate of both ALND and resident exposure over time.
Methods:
We identified women with clinical Stage I-III breast cancer in the National Cancer Data Base (2004-2014). Adjusted multivariate logistic regression was used to estimate the effect of various factors on receipt of ALND. Yearly procedural rates for residents were extracted from surgical case log reports for comparison against procedural rates.
Results:
1,131,363 patients were identified; 255,306 received ALND, 876,057 underwent non-ALND management. ALND rates declined from 2004 (32%) to 2014 (16%, p < 0.001), with the largest decline occurring between 2010 and 2011 (24%-20%). After adjustment, this effect was maintained, with ALND rates decreasing with each additional year (OR = 0.90, 95% CI 0.89-0.90). Resident procedure volumes similarly declined from 1999 to 2017 (p < 0.001).
Conclusions:
Significant declines in both ALND rates and procedural volume in residency may impact outcomes, as ALNDs are being performed in ever more challenging oncologic scenarios by potentially less-experienced surgeons.
More Related Videos
06:37Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Published on: October 20, 2010
04:01Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Related Concept Videos
01:14Decreased pulse rate
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
01:05Noncompartmental Analysis: Mean Residence Time
After the administration of a drug through intravenous bolus injection, the drug molecules are distributed throughout the body and remain there for varying periods. The MRT represents the average time these drug molecules stay in the...
01:23Detailed Structure and Function of Lymph Nodes
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
02:39The Integrated Rate Law: The Dependence of Concentration on Time
01:29Decreased Body Temperature
02:53Reaction Rate
The mathematical representation of the change in the concentration of reactants and products, over time, is the rate...