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The use of sentinel lymph node biopsy in the treatment of breast ductal carcinoma in situ: A Danish population-based study

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@article{7c19d4ae40b74bd08087594244c203ff,
title = "The use of sentinel lymph node biopsy in the treatment of breast ductal carcinoma in situ: A Danish population-based study",
abstract = "OBJECTIVES: The risk of axillary metastases in breast cancer patients with only ductal carcinoma in situ (DCIS) is low. Thus, axillary staging with sentinel lymph node biopsy (SLNB) should only be used according to the current guidelines to avoid over-treatment and unnecessary morbidity. In the present study, the use of SLNB in patients with DCIS was evaluated nationally and compared across Danish departments.MATERIAL AND METHODS: A register-based study was conducted using the Danish Breast Cancer Group database. The use of SLNB in DCIS patients according to year of diagnosis, age at diagnosis, size of lesion, Van Nuys classification, palpability, location and department of surgery was evaluated. The chi-squared test was used to test differences between the groups.RESULTS: Data from 2618 Danish female patients diagnosed with DCIS between 2004 and 2015 were included; 54.3{\%} of patients underwent SLNB. The use of SLNB increased from 26.6{\%} in 2004 to 65.1{\%} in 2015. A total of 1877 (71.7{\%}) patients underwent breast-conserving surgery (BCS), and 577 (22.0{\%}) underwent mastectomy, of which 43.9{\%} and 86.0{\%} respectively had a concomitant SLNB. The SLNB was performed in 23.8{\%} of 454 patients not included by the guidelines. The use of SLNB in combination with BCS differed significantly between departments ranging from 19.7{\%} to 63.8{\%}. A significant difference in the use of SLNB with BCS and mastectomy according to department capacity (high-volume departments versus low-volume departments) was observed.CONCLUSION: The use of SLNB in patients with DCIS and adherence to the Danish national guidelines varies among Danish breast surgery departments. To optimise the axillary treatment of patients with DCIS, an improved compliance to the national DCIS guidelines is necessary.",
keywords = "Adult, Aged, Breast Neoplasms, Carcinoma, Intraductal, Noninfiltrating, Chi-Square Distribution, Databases, Factual, Denmark, Female, Guideline Adherence, Healthcare Disparities, Hospitals, High-Volume, Hospitals, Low-Volume, Humans, Lymph Nodes, Lymphatic Metastasis, Mammography, Middle Aged, Neoplasm Staging, Odds Ratio, Practice Guidelines as Topic, Practice Patterns, Physicians', Predictive Value of Tests, Registries, Risk Assessment, Risk Factors, Sentinel Lymph Node Biopsy, Comparative Study, Journal Article",
author = "Holm-Rasmussen, {Emil Villiam} and Maj-Britt Jensen and Eva Balslev and Niels Kroman and Tvedskov, {Tove Filtenborg}",
note = "Copyright {\circledC} 2017 Elsevier Ltd. All rights reserved.",
year = "2017",
month = "12",
doi = "10.1016/j.ejca.2017.09.037",
language = "English",
volume = "87",
pages = "1--9",
journal = "European Journal of Cancer, Supplement",
issn = "0959-8049",
publisher = "Pergamon",

}

RIS

TY - JOUR

T1 - The use of sentinel lymph node biopsy in the treatment of breast ductal carcinoma in situ

T2 - A Danish population-based study

AU - Holm-Rasmussen, Emil Villiam

AU - Jensen, Maj-Britt

AU - Balslev, Eva

AU - Kroman, Niels

AU - Tvedskov, Tove Filtenborg

N1 - Copyright © 2017 Elsevier Ltd. All rights reserved.

PY - 2017/12

Y1 - 2017/12

N2 - OBJECTIVES: The risk of axillary metastases in breast cancer patients with only ductal carcinoma in situ (DCIS) is low. Thus, axillary staging with sentinel lymph node biopsy (SLNB) should only be used according to the current guidelines to avoid over-treatment and unnecessary morbidity. In the present study, the use of SLNB in patients with DCIS was evaluated nationally and compared across Danish departments.MATERIAL AND METHODS: A register-based study was conducted using the Danish Breast Cancer Group database. The use of SLNB in DCIS patients according to year of diagnosis, age at diagnosis, size of lesion, Van Nuys classification, palpability, location and department of surgery was evaluated. The chi-squared test was used to test differences between the groups.RESULTS: Data from 2618 Danish female patients diagnosed with DCIS between 2004 and 2015 were included; 54.3% of patients underwent SLNB. The use of SLNB increased from 26.6% in 2004 to 65.1% in 2015. A total of 1877 (71.7%) patients underwent breast-conserving surgery (BCS), and 577 (22.0%) underwent mastectomy, of which 43.9% and 86.0% respectively had a concomitant SLNB. The SLNB was performed in 23.8% of 454 patients not included by the guidelines. The use of SLNB in combination with BCS differed significantly between departments ranging from 19.7% to 63.8%. A significant difference in the use of SLNB with BCS and mastectomy according to department capacity (high-volume departments versus low-volume departments) was observed.CONCLUSION: The use of SLNB in patients with DCIS and adherence to the Danish national guidelines varies among Danish breast surgery departments. To optimise the axillary treatment of patients with DCIS, an improved compliance to the national DCIS guidelines is necessary.

AB - OBJECTIVES: The risk of axillary metastases in breast cancer patients with only ductal carcinoma in situ (DCIS) is low. Thus, axillary staging with sentinel lymph node biopsy (SLNB) should only be used according to the current guidelines to avoid over-treatment and unnecessary morbidity. In the present study, the use of SLNB in patients with DCIS was evaluated nationally and compared across Danish departments.MATERIAL AND METHODS: A register-based study was conducted using the Danish Breast Cancer Group database. The use of SLNB in DCIS patients according to year of diagnosis, age at diagnosis, size of lesion, Van Nuys classification, palpability, location and department of surgery was evaluated. The chi-squared test was used to test differences between the groups.RESULTS: Data from 2618 Danish female patients diagnosed with DCIS between 2004 and 2015 were included; 54.3% of patients underwent SLNB. The use of SLNB increased from 26.6% in 2004 to 65.1% in 2015. A total of 1877 (71.7%) patients underwent breast-conserving surgery (BCS), and 577 (22.0%) underwent mastectomy, of which 43.9% and 86.0% respectively had a concomitant SLNB. The SLNB was performed in 23.8% of 454 patients not included by the guidelines. The use of SLNB in combination with BCS differed significantly between departments ranging from 19.7% to 63.8%. A significant difference in the use of SLNB with BCS and mastectomy according to department capacity (high-volume departments versus low-volume departments) was observed.CONCLUSION: The use of SLNB in patients with DCIS and adherence to the Danish national guidelines varies among Danish breast surgery departments. To optimise the axillary treatment of patients with DCIS, an improved compliance to the national DCIS guidelines is necessary.

KW - Adult

KW - Aged

KW - Breast Neoplasms

KW - Carcinoma, Intraductal, Noninfiltrating

KW - Chi-Square Distribution

KW - Databases, Factual

KW - Denmark

KW - Female

KW - Guideline Adherence

KW - Healthcare Disparities

KW - Hospitals, High-Volume

KW - Hospitals, Low-Volume

KW - Humans

KW - Lymph Nodes

KW - Lymphatic Metastasis

KW - Mammography

KW - Middle Aged

KW - Neoplasm Staging

KW - Odds Ratio

KW - Practice Guidelines as Topic

KW - Practice Patterns, Physicians'

KW - Predictive Value of Tests

KW - Registries

KW - Risk Assessment

KW - Risk Factors

KW - Sentinel Lymph Node Biopsy

KW - Comparative Study

KW - Journal Article

U2 - 10.1016/j.ejca.2017.09.037

DO - 10.1016/j.ejca.2017.09.037

M3 - Journal article

VL - 87

SP - 1

EP - 9

JO - European Journal of Cancer, Supplement

JF - European Journal of Cancer, Supplement

SN - 0959-8049

ER -

ID: 52341510