Featured Research

from universities, journals, and other organizations

Uneven Use Of Less-invasive Breast Cancer Staging Test Reported

Date:
March 25, 2008
Source:
Journal of the National Cancer Institute
Summary:
The use of sentinel lymph node biopsy during breast cancer surgery increased substantially from 1998 through 2005, according to a new article. However, non-white women, older women, and those living in poorer areas of the US were less likely to receive SLNB than their counterparts who are white, younger, or from more affluent areas, respectively.

The use of sentinel lymph node biopsy (SLNB) during breast cancer surgery increased substantially from 1998 through 2005, according to a new article. However, non-white women, older women, and those living in poorer areas of the U.S. were less likely to receive SLNB than their counterparts who are white, younger, or from more affluent areas, respectively.

Related Articles


A key prognostic factor for breast cancer is whether or not the disease has spread beyond the breast tissue into neighboring lymph nodes. To look for such invasion, surgeons can remove many lymph nodes in a procedure called axillary lymph node dissection (ALND) or only a few in the SLNB procedure. In 1998, clinical care guidelines changed, allowing surgeons to use SLNB for certain patients. SLNB is associated with easier recovery and fewer long-term problems for patients than ALND.

In the current study, Amy Y. Chen, M.D., of Emory University and the American Cancer Society in Atlanta and colleagues examined patient data from a national hospital-based cancer registry to determine how frequently SLNB had been used between 1998 and 2005. They also looked at whether patient-related factors or the type of treatment facility affected a woman's chance of receiving SLNB over ALND.

The researchers identified 490,899 women in the National Cancer Database who underwent breast cancer surgery during the study period and had a stage of disease for which SLNB would be appropriate. The proportion of these patients who underwent SLNB increased from 26.8 percent to 65.5 percent during the study period. However, not all women were equally likely to undergo SLNB. Non-white women, women aged 72 years or older, and those who lived in zip code areas that had a lower proportion of high school graduates or lower median incomes were less likely than women who were white, younger, or from more educated or affluent regions to undergo SLNB.

Disparities between these groups persisted from 1998 through 2005. For example, in 1998, 29 percent of white women received SLNB, compared with 26 percent among African American women and 35 percent among Hispanic women. In 2005, these rates rose to 70 percent, 64 percent, and 67 percent, respectively.

The clinical guidelines recommend that SLNB only be performed in facilities that have teams experienced with the procedure. While the use of SLNB increased over time in all types of hospitals, data were not available to assess whether disparities in access to SLNB were related to lack of experience with the procedure in facilities that were treating poorer women.

"The disparities that were related to receipt of SLNB in this study are particularly important in light of the clinical advantages associated with this technique. Better outcomes have been reported for patients receiving SLNB than for patients receiving ALND," the authors write.

In an accompanying editorial, Stephen B. Edge, M.D., of Roswell Park Cancer Institute in Buffalo, N.Y., describes the history of sentinel lymph node biopsy and its rapid acceptance among breast cancer surgeons. The incorporation of the technique preceded outcome data from large randomized trials. In this instance, such enthusiasm appears to have been well placed, he writes, but a more cautious approach with new interventions should be observed in general.

Despite the eagerness of surgeons to use the technique, not all patients have equal access to the less invasive approach. "Given America's track record of disparate care, I suppose we should not be surprised that racial and ethnic minorities were disproportionately deprived of another medical advance. However, this observation is profoundly disappointing and sobering. It is yet another call for us to redouble efforts to identify and correct the root causes of disparities," Edge writes.

Journal reference: Chen AY, Halpern MT, Schrag NM, Stewart A, Leitch M, Ward E. Disparities and Trends in Sentinel Lymph Node Biopsy Among Early-Stage Breast Cancer Patients (1998 -- 2005). J Natl Cancer Inst 2008; 100:462-474


Story Source:

The above story is based on materials provided by Journal of the National Cancer Institute. Note: Materials may be edited for content and length.


Cite This Page:

Journal of the National Cancer Institute. "Uneven Use Of Less-invasive Breast Cancer Staging Test Reported." ScienceDaily. ScienceDaily, 25 March 2008. <www.sciencedaily.com/releases/2008/03/080325163815.htm>.
Journal of the National Cancer Institute. (2008, March 25). Uneven Use Of Less-invasive Breast Cancer Staging Test Reported. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2008/03/080325163815.htm
Journal of the National Cancer Institute. "Uneven Use Of Less-invasive Breast Cancer Staging Test Reported." ScienceDaily. www.sciencedaily.com/releases/2008/03/080325163815.htm (accessed November 27, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com
From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins