Concordant care in sentinel lymph node omission following Choosing Wisely® recommendations at a comprehensive cancer center - 12/12/23
, Cynthia Ong a, Jamal Khan a, Xiaoyan Deng b, Dipankar Bandyopadhyay b, Raphael J. Louie c, Kandace P. McGuire c, ⁎ Abstract |
Background |
In 2016, the SSO and ABIM released a Choosing Wisely® guideline stating SLNB can be safely omitted in women ≥70 with HR + HER-invasive breast cancer. No study evaluating concordance of care with this guideline has been performed within a comprehensive cancer center.
Methods |
From 2005 to 2020, there were 382 patients with cT1-2N0 invasive carcinoma ER+/PR+ and HER2-identified as having undergone SLNB. These patients were then separated into two groups; those in the pre-guideline concordance cohort (2005–2015) and those in the post-guideline concordance (2016–2020) cohort. Axillary management concordance was trended over time.
Results |
382 patients from 2005 to 2020 with HR + HER- IBC were identified. No difference was seen in SLNB pre-versus post-guidelines (p = 0.35). Increased concordance was noted as age increased (p = 0.0068) and adjuvant radiation therapy exclusion (p < 0.0001) post-guideline release. Concordance improved over the years post-guideline release (R2 = 0.45).
Conclusions |
Surgical guideline adoption occurs over time but may also be affected by outside decisions and factors. Further study into patterns of guideline adoption may facilitate improving adherence to guidelines.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Choosing Wisely Guideline Concordance increased as time progressed. |
• | Increasing age is a factor associated with increased guideline concordance. |
• | Adjuvant radiation therapy exclusion is associated with increased concordance. |
Keywords : Breast cancer, Guideline concordance, Sentinel lymph node biopsy, Elderly population, Choosing wisely guideline, Trends over time
Plan
Vol 227
P. 183-188 - janvier 2024 Retour au numéro
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