Document Detail


A further survey of surgical management of the axilla in UK breast cancer patients.
MedLine Citation:
PMID:  20522293     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The aims of this study were to investigate the practice of axillary lymph node management within different units throughout the UK, and to assess changes in practice since our previous survey in 2004.
SUBJECTS AND METHODS: A structured questionnaire was sent to 350 members of the British Association of Surgical Oncology.
RESULTS: There were 177 replies from respondents who managed more than 100 patients a year with breast cancer. Of these: 12 did not perform axillary ultrasound at all in their centre; 17 (10%) employed axillary node clearance (ANC) on all patients; 122 (69%) performed sentinel node biopsy (SNB) with dual localisation; and 111 respondents had attended the New Start Course. Radioisotope was most frequently injected 2 h or more before operation. Just 13 surgeons were convinced of the value of dissecting internal mammary nodes visualised on a scan. Reasons for not using dual localisation included lack of nuclear medicine facilities, no local ARSAC licence holder, no probe, and no funding. Sixty-six surgeons stated that, if they had an ARSAC licence and could inject the radioactivity in theatre, this would be a major improvement. In addition, 83 (47%) did not perform SLNB in patients receiving neo-adjuvant chemotherapy.
CONCLUSIONS: Despite significant changes since 2004, substantial variation remains in management of the axilla. A number of surgeons are practicing outwith current guidelines.
Authors:
Ronan W Glynn; Linda Williams; J Michael Dixon
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-06-01
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  92     ISSN:  1478-7083     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-07     Completed Date:  2010-10-13     Revised Date:  2011-11-14    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  506-11     Citation Subset:  IM    
Affiliation:
Edinburgh Breast Unit, Western General Hospital, Edinburgh, UK.
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MeSH Terms
Descriptor/Qualifier:
Axilla / ultrasonography
Breast Neoplasms* / drug therapy,  pathology,  surgery,  ultrasonography
Chemotherapy, Adjuvant
Female
Health Care Surveys
Humans
Lymph Node Excision / methods*
Lymphatic Metastasis
Neoadjuvant Therapy
Patient Selection
Professional Practice / statistics & numerical data
Sentinel Lymph Node Biopsy / utilization

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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