Sentinel node biopsy for early breast cancer in <scp>Q</scp>ueensland, <scp>A</scp>ustralia, during 2008–2012

Dasgupta, Paramita; Youl, Philippa; Pyke, Chris; Aitken, Joanne F.; Baade, Peter D.

doi:10.1111/ans.14047

Cited by 4 publications

(6 citation statements)

References 26 publications

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“…28,30,31 The opening of new radiotherapy facilities in rural regions is associated with improved access and utilisation for radiotherapy. 28,32 Accessibility/Remoteness Index of Australia did not significantly predict for type of breast or axillary surgical procedures in our study, which differs from other literature in the Australian setting in which non-metropolitan women were consistently less likely to undergo SLNB 15,16,33 and BCS. 19,34 Given the well-documented inequitable cancer care across population subgroups by geographical location in Australia, this finding is encouraging.…”

Section: Agecontrasting

confidence: 99%

“…This is likely a reflection of the gradual adoption of the national guidelines published by Cancer Australia in 2008 21 and mirrors other published national and international shift in clinical practice of axillary staging around this same period. 16,33,40 We have also observed a temporal increase in the rate of RTU from 61.4% in 2009 to 65.1% in 2014 (OR: 1.41, CI: 1.28-1.56) (Table 5). This uptrend was not seen in conjunction with any statistically significant temporal changes in the rates of BCS (Table 3).…”

Section: Temporal Trendsmentioning

confidence: 74%

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Surgical and radiotherapy patterns of care in the management of breast cancer in NSW and ACT Australia

et al. 2021

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Introduction This study aims to report on the surgical and radiotherapy patterns of breast cancer care in New South Wales (NSW) and Australian Capital Territory (ACT) in Australia, to identify factors that impact on utilisation of evidence‐based treatment and to report on the overall survival (OS) rate and the influencing factors on OS. Methods Cancer registry data linked to hospital records for all patients with breast cancer diagnosis in NSW and ACT between 2009 and 2014 were used to calculate rates of breast conserving surgery (BCS), mastectomy, sentinel lymph node biopsy (SLNB), axillary lymph node dissection (ALND) and radiotherapy. Multivariate analysis used to identify factors that led to variations in care. 5‐year OS was calculated and cox regression model assessed factors that influenced survival. Results Data for 30,337 patients were analysed. BCS and mastectomy rates were 64% and 36%, respectively. The SLNB, ALND and ALND after SLNB rates were 61.5%, 32.1% and 6.4%, respectively. Radiotherapy was utilised in 63%. Younger age, socio‐economic disadvantage, longer distance to a radiotherapy facility and overseas place of birth were factors that predicted for increased rates of mastectomy and ALND. Radiotherapy was more likely to be utilised in later years of diagnosis, patients between 40‐69 years old, and those who lived in major cities and closer to a radiotherapy facility. 5‐year OS was 80.5%. Older patients, the socioeconomically disadvantaged and those advanced tumours had worse survival. Conclusion Variations in breast cancer care continue to exist in certain patient groups that we identified. Targeted strategic planning and further research to identify other drivers of existing disparities remain a priority.

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Section: Agecontrasting

confidence: 99%

Section: Temporal Trendsmentioning

confidence: 74%

Surgical and radiotherapy patterns of care in the management of breast cancer in NSW and ACT Australia

et al. 2021

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“…Retrospective and randomized studies did not find a difference in survival between these two methods. Similar results were obtained in 12-year and 20-year follow-up studies comparing these two methods [7][8][9][10] .…”

Section: Discussionsupporting

confidence: 84%

The Role Of Breast-Conserving Surgery In The Treatment Of Early-Stage Breast Cancer

Çiftçi

2020

Dicle Tıp Dergisi

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Objective: In the treatment of early-stage breast cancer, breast-conserving surgical treatment has been increasingly used. In our study, we investigated the survival efficacy in the long-term follow-up of breast-conserving surgical treatment in patients without axillary lymph node metastasis.Method: Thirty-nine patients without axillary lymph node metastasis who had undergone surgery for infiltrating ductal breast cancer between 2009 and 2018 were recordedin the research. Of these patients, 23 (58.9%) undergo MRM (modified radical mastectomy)and 16 (41.0%) undergo BCS (breast-conserving surgery). All of the patients who underwent BCS were given radiotherapy, and the patients with T2 and T3 tumors in two groups were given adjuvant chemotherapy and hormonotherapy according to receptor status. The patients were followed up by physical examination and imaging methods every three months in the first two years and then every six months.Results: All patients were followed up during the study (6 -96 months). There was not variations between the 2 groups in terms of patient age, tumor localization, menopausal status, and the number of lymph nodes dissected. Local recurrence was detected in 1 (6.2%) patient who underwent BCS and was treated with a total mastectomy. In another patient, lung and liver metastases were detected in the 7th year. Infiltrative ductal carcinoma of the contralateral breast was detected in 3 (13%) patients who underwent MRM between 12-24 months. No patients were lost in either group. Conclusion:In patients with early breast cancer, BCS was found to be disease-free and as safe as MRM surgeries for overall survival.

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“…Nevertheless, SLNB still has postoperative complications, such as a 0–7% incidence of lymphedema and a 20% incidence of upper limb numbness ( 25 , 26 ). Furthermore, the radionuclide labeling, blue dye injection and fluorescent dye methods used in SLNB are not only invasive, but also have a low diagnostic accuracy rate due to the difficulty of lymph node puncture ( 27 , 28 ). Moreover, performing SLNB for all patients with wastes limited medical resources and increases the financial burden on the patients.…”

Section: Discussionmentioning

confidence: 99%

A model for the early identification of sentinel lymph node metastasis in patients with breast cancer based on contrast‑enhanced ultrasound and clinical features

2022

Oncol Lett

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The present study was designed to establish a model for the early identification of sentinel lymph node (SLN) metastasis in patients with breast cancer (BC). The SLN metastasis predictive model was established with a retrospective training set of 365 patients with BC and was re-evaluated using a prospective validation set of 402 patients with BC. The multivariable analysis indicated that the tumor diameter [odds ratio (OR), 1.189; 95% confidence interval (CI), 1.124-1.257; P<0.001], menopause (OR, 1.011; 95% CI, 0.603-1.436; P<0.001), estrogen receptor (ER) expression (OR, 3.199; 95% CI, 1.077-6.567; P= 0.043) and contrast-enhanced ultrasonography (CEUS) type (OR, 10.563; 95% CI, 6.890-28.372; P<0.001) were independent predictors of SLN status in patients with BC. The SLN metastasis predictive model was as follows: (0.173 x tumor diameter)-(4.490 x menopause) + (2.322 x ER) + (5.445 x CEUS type)-1.9521. In the training set, the model was highly sensitive (83.6%) and specific (94.3%) for the early identification of SLN metastasis. Similarly, in the validation set, the model was highly sensitive (70.4%) and specific (89.5%) for the early identification of SLN metastasis in patients with BC. Overall, in the present study, a model was successfully established to predict SLN metastasis in patients with BC that includes tumor diameter, menopausal status, ER expression and CEUS detection.

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Sentinel node biopsy for early breast cancer in Queensland, Australia, during 2008–2012

Abstract: Geographical disparities to accessing SNB persist. Efforts to promote multidisciplinary care and facilitate education in healthcare changes through innovative solutions using emerging technologies as well as targeted research to identify the barriers to equitable access remain critical.

Cited by 4 publications

References 26 publications

Surgical and radiotherapy patterns of care in the management of breast cancer in NSW and ACT Australia

Surgical and radiotherapy patterns of care in the management of breast cancer in NSW and ACT Australia

The Role Of Breast-Conserving Surgery In The Treatment Of Early-Stage Breast Cancer

A model for the early identification of sentinel lymph node metastasis in patients with breast cancer based on contrast‑enhanced ultrasound and clinical features

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