Learning curves and breast cancer lymphatic mapping: institutional volume index

The Journal of Surgical Research
E DupontD S Reintgen

Abstract

To date, studies of breast cancer lymphatic mapping (LM) have analyzed success with respect to individual surgeons. However, LM and sentinel lymph node biopsy (SLNBx) are procedures that require institutional multidisciplinary cooperation between the departments of radiology, pathology, and surgery. Thus, it is important to evaluate these procedures with respect to the institution. This study examines 30 institutions to clarify the value of the institutional volume index (IVI) (cases/month) to the outcome of LM and SLNBx in breast cancer. From July 1997 to July 1999, 30 institutions participated in the Department of Defense national breast LM trial. All participants underwent a 2-day training course for surgeons, nuclear medicine physicians, and pathologists. The records for each institution were prospectively accrued and submitted to a database. The false negatives, failure rates, and IVI were calculated for each institution. A logistic regression model plots the relationship between IVI and institutional failure rate. Using a multivariate analysis, mapping failure was analyzed as a function of case number with respect to the individual surgeon and the institution as a whole. False negative results were demonstrated in only 5 ...Continue Reading

References

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Citations

Mar 11, 2004·The Breast Journal·Richard L EllisGary L Dunnington
Jul 9, 2004·The Breast Journal·Celia ChaoUNKNOWN University of Louisville Breast Cancer Study Group
Dec 7, 2013·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Wenbin GuoMeng Tong
Feb 17, 2010·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·Paula ManchonUNKNOWN Breast Cancer OncoGuia Group
Jun 7, 2011·Surgical Oncology Clinics of North America·Diana Dickson-WitmerEmily J Penman
Apr 16, 2010·The Breast : Official Journal of the European Society of Mastology·Lisa Bailey
Jul 1, 2008·Gynecologic Oncology·James OrrTrevor Tejada-Berges
May 13, 2008·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·P A BakerS Stephenson
Nov 26, 2005·American Journal of Surgery·Julie R HutchinsonUNKNOWN University of Louisville Breast Sentinel Lymph Node Study
Jul 24, 2003·The Surgical Clinics of North America·Thomas A BuchholzKelly K Hunt
Jun 5, 2003·American Journal of Surgery·William C Jennings
Feb 6, 2014·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Yoon Jin LeeSeung-Moon Joo
Jan 30, 2007·The British Journal of Surgery·M M ChowdhuryA Pierro
Jun 25, 2003·British Journal of Neurosurgery·E J CunninghamB A Bell

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