Sentinel node biopsy for early breast cancer in Queensland, Australia, during 2008–2012
2018
Background: Sentinel node biopsy (SNB) is now the standard of care for women with earlystage
breast cancer. Despite lower morbidity than axillary lymph node dissection, widespread
variation in SNB rates by non-clinical factors persists. We explored the factors associated with
SNB usage and changes in those associations over time for recently diagnosed women.
Methods: We report here on a linked population-based cancer registry and hospital inpatient
admission data set for 5577 women aged at least 20 years diagnosed with a first primary
invasive early-stage node-negative breast cancer from July 2008 to 2012 in
Queensland, Australia, who underwent breast cancer-related surgery within 2 years of diagnosis.
Multivariate logistic regression was used to model predictors of SNB separately for
5172 women with ≤30 mm tumours and 405 with 31 to ≤50 mm tumours.
Results: Overall, 3972 (77%) women with ≤30 mm tumours and 221 (55%) of those with
larger tumours underwent SNB. Usage increased over time for both cohorts but was consistently
lower among those with larger tumours. A more recent diagnosis, having breastconserving
surgery, living in more accessible areas and attending a private or high-volume
hospital independently increased the odds of SNB for both cohorts. There was no evidence
that the geographical disparity had reduced over the study period for either cohort.
Conclusion: Geographical disparities to accessing SNB persist. Efforts to promote multidisciplinary
care and facilitate education in healthcare changes through innovative solutions
using emerging technologies as well as targeted research to identify the barriers to equitable
access remain critical.
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