Publication

Guideline adherence for early breast cancer before and after introduction of the sentinel node biopsy

Schaapveld, M., de Vries, EGE., Otter, R., de Vries, J., Dolsma, WV. & Willemse, PHB., 5-Sep-2005, In : British Jounal of Cancer. 93, 5, p. 520-528 9 p.

Research output: Contribution to journalArticleAcademicpeer-review

Copy link to clipboard

Documents

DOI

This population-based study aimed to analyse variations in surgical treatment and guideline compliance with respect to the application of radiotherapy and axillary lymph node dissection (ALND), for early breast cancer, before and after the sentinel node biopsy (SNB) introduction. The study included 13 532 consecutive surgically treated stage I - IIIA breast cancer patients diagnosed in 1989 - 2002. Hospitals showed large variation in breast-conserving surgery (BCS) rates, ranging between 27 and 72% for T1 and 14 and 42% for T2 tumours. In multivariate analysis marked inter-hospital and time-dependent variation in the BCS rate remained after correction for case-mix. The guideline adherence was markedly lower for elderly patients. In 25.2% of the patients aged >= 75 years either ALND or radiotherapy were omitted. The proportion of patients with no ALND after an SNB increased from 1.8% in 1999 to 37.8% in 2002. However, in 2002 also 12.2% of the patients with a positive SNB did not have an ALND. Guideline compliance for BCS, with respect to radiotherapy and ALND, fell since the SNB introduction, from 96.1% before 2000 to 91.4% in 2002 (P

Original languageEnglish
Pages (from-to)520-528
Number of pages9
JournalBritish Jounal of Cancer
Volume93
Issue number5
Publication statusPublished - 5-Sep-2005

    Keywords

  • breast cancer, regional variation, breast-conserving surgery, guideline adherence, sentinel node biopsy, QUALITY-OF-LIFE, STAGE-I, AXILLARY DISSECTION, CONSERVING THERAPY, SURGICAL-TREATMENT, RADIATION-THERAPY, ELDERLY-WOMEN, OLDER WOMEN, ADJUVANT RADIOTHERAPY, GEOGRAPHIC-VARIATION

View graph of relations

Download statistics

No data available

ID: 4360208