Intraoperative training on the techniques of sentinel node biopsy in breast cancer

Details

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Version: After imprimatur
Serval ID
serval:BIB_A9721B733B09
Type
PhD thesis: a PhD thesis.
Collection
Publications
Institution
Title
Intraoperative training on the techniques of sentinel node biopsy in breast cancer
Author(s)
Cuchard P.
Director(s)
Delaloye  J.-F.
Codirector(s)
Pampallona  S., Fattouche  V., Monod  J.-F.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Address
Faculté de biologie et de médecineUniversité de LausanneUNIL - BugnonRue du Bugnon 21 - bureau 4111CH-1015 LausanneSUISSE
Publication state
Accepted
Issued date
2011
Language
english
Number of pages
16
Abstract
Principles: Surgeon's experience is crucial for proper application of sentinel node biopsy (SNB) in patients with breast cancer. A 20-30 cases learning curve of sentinel node (SN) and axillary lymph node dissection (ALND) was widely practiced. In order to speed up this learning curve, surgeons may be trained intraoperative by an experienced surgeon. The purpose of this report is to evaluate the results of this procedure.
Methods: Patients with one primary invasive breast cancer (cT1-T2[<3 cm]cN0) underwent SNB based on lymphoscintigraphy using technetium Tc 99m colloid, intraoperative gamma probe detection, with or without blue dye mapping. This was followed by completion ALND when SN was positive or not found. SNB was performed by one experienced surgeon (teacher) or by 10 junior surgeons trained by the experienced surgeon (trainees). Four groups were defined: (i) SNB with immediate ALND for the teacher's learning curve, (ii) SNB by the teacher, (iii) SNB by the trainees under the teacher's supervision, and (iv) SNB by the trainees alone. Results: Between May 1999 and December 2007, a total of 808 évaluable patients underwent SNB. The SN identification rate was 98% in the teacher's group, and 99% in the trainees' group (p = 0.196). SN were positive in respectively 28% and 29% of patients (p = 0.196). The distribution of isolated tumor cells, micrometastases and metastases was not statistically different between the teacher's and the trainees' groups (p = 0.163).
Conclusion: These comparable results confirm the success with which the SNB was taught. This strategy avoided the 20-30 SNB followed by immediate ALND early required per surgeon.
Keywords
breast cancer, sentinel node biopsy, axillary lymph node dissection, learning curve
Create date
26/04/2012 10:55
Last modification date
20/08/2019 15:13
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