Use of sentinel lymph node biopsy in elderly patients with breast cancer – 10-year experience from a Swiss university hospital

World Journal of Surgical Oncology

Research

Ruth S. Eller¹  Julie M. Loesch¹  Madleina Mueller¹  Christian Kurzeder²  Nadia Maggi²  Walter P. Weber²  Fabienne D. Schwab²  Martin Heidinger³  Gilles Dutilh⁴ 

[1] Breast Center, University Hospital Basel, Basel, Switzerland;Breast Center, University Hospital Basel, Basel, Switzerland;University of Basel, Basel, Switzerland;Breast Center, University Hospital Basel, Basel, Switzerland;University of Basel, Basel, Switzerland;Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland;Department of Clinical Research, University Hospital Basel, Basel, Switzerland;

关键词: Breast cancer;    Breast cancer surgery;    Axillary surgery;    Axillary staging;    Sentinel lymph node biopsy;    Elderly;   

DOI  :  10.1186/s12957-023-03062-1

 received in 2023-03-15, accepted in 2023-06-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe Choosing Wisely initiative recommended the omission of routine sentinel lymph node biopsy (SLNB) in patients ≥ 70 years of age, with clinically node-negative, early stage, hormone receptor (HR) positive and human epidermal growth factor receptor 2 (Her2) negative breast cancer in August 2016. Here, we assess the adherence to this recommendation in a Swiss university hospital.MethodsWe conducted a retrospective single center cohort study from a prospectively maintained database. Patients ≥ 18 years of age with node-negative breast cancer were treated between 05/2011 and 03/2022. The primary outcome was the percentage of patients in the Choosing Wisely target group who underwent SLNB before and after the initiative went live. Statistical significance was tested using chi-squared test for categorical and Wilcoxon rank-sum tests for continuous variables.ResultsIn total, 586 patients met the inclusion criteria with a median follow-up of 2.7 years. Of these, 163 were ≥ 70 years of age and 79 were eligible for treatment according to the Choosing Wisely recommendations. There was a trend toward a higher rate of SLNB (92.7% vs. 75.0%, p = 0.07) after the Choosing Wisely recommendations were published. In patients ≥ 70 years with invasive disease, fewer received adjuvant radiotherapy after omission of SLNB (6.2% vs. 64.0%, p < 0.001), without differences concerning adjuvant systemic therapy. Both short-term and long-term complication rates after SLNB were low, without differences between elderly patients and those < 70 years.ConclusionsChoosing Wisely recommendations did not result in a decreased use of SLNB in the elderly at a Swiss university hospital.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 2