TY - JOUR
T1 - Geographic variation in sentinel node adaptation by practicing surgeons in Oregon
AU - Garreau, Jennifer R.
AU - Nelson, Joanne
AU - Cook, David
AU - Vetto, John
AU - Walts, Deb
AU - Homer, Louis
AU - Johnson, Nathalie
AU - Moonka, Ravi
PY - 2005/5
Y1 - 2005/5
N2 - Background: The sentinel node biopsy (SNB) technique is an important tool in the diagnosis and treatment of breast cancer and melanoma. However, surgeons in Oregon have not universally adopted its use. Methods: Mailed questionnaire. Results: The response rate was 32%. Seventy-four (76%) of the surgical respondents perform routine SNB; 49% completed courses, and 32% learned the technique in residency. Sixty-one (89%) performed axillary dissection with their initial cases. It took 21 of 40 (52%) surgeons greater than a year to accrue 20 cases. Of 23 surgeons (24%) not performing SNB, 89% believed it was an important skill to obtain, and 70% thought they would benefit from proctoring opportunities. Six (26%) did not have technological support at their hospital. Surgeons at hospitals with less than 50 beds (P = .001) and at rural hospitals (P = .003) were less likely to perform SNB. Conclusion: The majority of urban general surgeons in Oregon use SNB in their practice. However, the incorporation of SNB for surgeons practicing in smaller hospitals and rural settings is less frequent than in the urban environment. As SNB becomes the standard of care, we need to overcome these barriers so that patients can have access to this procedure in their own communities.
AB - Background: The sentinel node biopsy (SNB) technique is an important tool in the diagnosis and treatment of breast cancer and melanoma. However, surgeons in Oregon have not universally adopted its use. Methods: Mailed questionnaire. Results: The response rate was 32%. Seventy-four (76%) of the surgical respondents perform routine SNB; 49% completed courses, and 32% learned the technique in residency. Sixty-one (89%) performed axillary dissection with their initial cases. It took 21 of 40 (52%) surgeons greater than a year to accrue 20 cases. Of 23 surgeons (24%) not performing SNB, 89% believed it was an important skill to obtain, and 70% thought they would benefit from proctoring opportunities. Six (26%) did not have technological support at their hospital. Surgeons at hospitals with less than 50 beds (P = .001) and at rural hospitals (P = .003) were less likely to perform SNB. Conclusion: The majority of urban general surgeons in Oregon use SNB in their practice. However, the incorporation of SNB for surgeons practicing in smaller hospitals and rural settings is less frequent than in the urban environment. As SNB becomes the standard of care, we need to overcome these barriers so that patients can have access to this procedure in their own communities.
KW - Axillary node dissection
KW - Breast cancer
KW - Learning curve
KW - Sentinel node biopsy
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U2 - 10.1016/j.amjsurg.2005.01.039
DO - 10.1016/j.amjsurg.2005.01.039
M3 - Article
C2 - 15862507
AN - SCOPUS:18044380282
SN - 0002-9610
VL - 189
SP - 616
EP - 620
JO - American journal of surgery
JF - American journal of surgery
IS - 5 SPEC. ISS.
ER -