Beyond the False Negative Rate: Development of Quality Indicators for Sentinel Lymph Node Biopsy in Breast Cancer

Quan, May Lynn; Wells, Bryan J.; McCready, David R.; Wright, Frances C.; Fraser, Novlette; Gagliardi, Anna R.

doi:10.1245/s10434-009-0658-3

Cited by 18 publications

(13 citation statements)

References 23 publications

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“…After discussing these cases in a multidisciplinary panel of breast cancer specialists and taking into account the Memorial Sloan-Kettering Cancer Center Box 1. Sentinel lymph node biopsy quality indicator definitions 9 …”

Section: Resultsmentioning

confidence: 99%

“…To calculate the percentage, Quan and colleagues 9 proposed that only T1 tumours be used, excluding other eligible cases (e.g., T2N0, TisN0). Although SLNB is indicated for most T1 tumours, only 60% of them undergo this type of axillary staging.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the absence of QIs for SLNB, in 2010 Quan and colleagues 9 developed a series of quality measures along with proposed potential targets. A multidisciplinary panel of Canadian breast cancer experts convened to develop these indicators using a modified Delphi process.…”

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confidence: 99%

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Quality indicators for sentinel lymph node biopsy: Is there room for improvement?

Acuña

Angarita

McCready

et al. 2013

cjs

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Background: Eleven quality indicators (QIs) for sentinel lymph node biopsy (SLNB) were previously developed through a consensus-based approach, yet still need to be incorporated into clinical practice. We sought to evaluate the applicability and clinical relevance for surgeons.Methods: Breast cancer patients undergoing SLNB between 2004 and 2008 at Mount Sinai Hospital, Toronto, were evaluated. Clinical and pathological data were obtained from an institutional database. Information on axillary recurrences was obtained through a retrospective chart review. Adherence to standardized protocols was evaluated in each case.Results: All 11 QIs were measurable in 300 patients. The identification rate was 100%. More than 1 SLN was identified in 78.6% of patients. The SLNB was performed simultaneously with primary surgery in 96.7% of patients; 61 SLNs harboured metastasis. Of these patients, 80.3% underwent completion lymphadenectomy. Cases complied with protocols for radiocolloid injection and pathologic SLN evaluation/reporting. No ineligible patients underwent SLNB. Of patients with a complete 5-year follow-up (n = 42), only 1 had axillary recurrence. Conclusion:Applying QIs for SLNB was feasible, but modifications were necessary to develop a more practical approach to quality assessment. Of the 11 suggested QIs, those that encompass protocols (nuclear medicine and pathology) should be reclassified as prerequisites, as they are independent of the technical aspect of SLNB performance. The remaining 8 QIs encompass surgery per se and should be measured routinely by surgeons. Furthermore, concise and clinically relevant target rates are necessary for these QIs to be established as widely recognized control standards.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Quality indicators for sentinel lymph node biopsy: Is there room for improvement?

Acuña

Angarita

McCready

et al. 2013

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“…RCC is one of the most lethal genitourinary malignancies in North America. 17 Many health care providers are involved in the management of RCC, and the disease itself has a wide spectrum of severity from the favorable natural history of many small and localized tumors to the usually lethal metastatic RCC.…”

Section: Discussionmentioning

confidence: 99%

Using the Delphi Technique to Improve Clinical Outcomes Through the Development of Quality Indicators in Renal Cell Carcinoma

Wood

Bjarnason

Black

et al. 2013

JOP

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“…Eleven quality indicators for the performance of SLNB have been identified based on a consensus of Quan and colleagues [40]. These include: pathologic evaluation protocol, pathologic reporting by AJCC guideline, protocol for injection of radiocolloid, proper identification of SLN, SLNB performance in eligible patients, SLNB concurrent with lumpectomy/mastectomy, completion of ALND for positive SLNB, SLNB performance in ineligible patients, axillary node positivity rate; number of nodes removed; axillary recurrence rate.…”

Section: Future Developmentsmentioning

confidence: 99%

Sentinel Lymph Node Mapping: Current Practice and Future Developments

Klimberg

Tummel

2015

Imaging and Visualization in the Modern Operating Room

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Beyond the False Negative Rate: Development of Quality Indicators for Sentinel Lymph Node Biopsy in Breast Cancer

Abstract: A systematic evidence- and consensus-based approach was used to develop measurable quality indicators that could be used by practicing surgeons and administrators to evaluate performance of SLNB in breast cancer.

Cited by 18 publications

References 23 publications

Quality indicators for sentinel lymph node biopsy: Is there room for improvement?

Quality indicators for sentinel lymph node biopsy: Is there room for improvement?

Using the Delphi Technique to Improve Clinical Outcomes Through the Development of Quality Indicators in Renal Cell Carcinoma

Sentinel Lymph Node Mapping: Current Practice and Future Developments

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