NSABP
sentinel node trial: Training surgeons to participate
Interview
with Neil Love, MD from Breast Cancer Update for Surgeons,
Program 1 2000
Play
Audio Below:
The training process involves a site visit by a surgeon, who is
either myself or Seth Harlow or six other surgeons, who are part
of the original validation study. So, the idea is not to certify
a surgeon, its really to establish a standard technique. Its
a giant experiment and if were all doing different things
well come out with answers that arent as valid. So,
part of the site visit is to do it in a very set technique that
we feel works fairly well, although theres other techniques.
And, the surgeon does five training cases subsequent to that visit.
Once theyve completed five training cases, which involves
not only actually performance of this technique and be validated.
Surgeons have not been dominant in management of clinical trials.
All right? They just havent, even though theres leaders
in organizations, the surgeons out there, I dont care whether
its in a university or wherever, have not been the ones running
these trials. So, for a surgeon now, hes got to enter data.
This is not typical and so, a big part of this training is making
sure that all this data is filled in correctly and its very
valuable process.
Dr.
Love: How long does a training take you, the on site training?
Dr.
Krag: The site visit is one day.
Dr.
Love: Do you actually do a procedure?
Dr.
Krag: I actually do a procedure.
Dr.
Love: One?
Dr.
Krag: One or two. We train up to two people that day at an organization
and then we also meet with pathology, nuclear medicine, nursing
personnel. Really make a whole site visit so that everybody understands
issues of radioactivity, the pathologists understand how we are
going to do the processing of the lymph nodes and get kind of everybody
harmonious and on the same team here.
Is
routine intraoperative frozen-section examination of sentinel lymph
nodes in breast cancer worthwhile Weiser, M. R.; Montgomery,
L. L.; Susnik, B.; Tan, L. K.; Borgen, P. I., and Cody, H. S.? Annals
of Surgical Oncology. 7(9):651-655, 2000 Oct. In progress
Micrometastatic
nodal disease in breast cancer - The dilemma continues. Rose,
M. D. and Giuliano, A. E. (Reprint available from: Giuliano
AE St Johns Hlth Ctr, John Wayne Canc Inst 2200 Santa Monica Blvd
Santa Monica, CA 90404 USA). Journal of Surgical Oncology. 74(2):87-89,
2000 Jun. No abstract
Variation
in axillary node dissection influences the degree of nodal involvement
in breast cancer patients.
Saha, S.; Farrar, W. B.; Young, D. C.; Ferrara, J. J., and Burak,
W. E.. Journal of Surgical Oncology. 73(3):134-137, 2000 Mar.
A
multicenter validation study of sentinel lymph node biopsy by the
Japanese Breast Cancer Society.
Noguchi, M.; Motomura, K.; Imoto, S.; Miyauchi, M.; Sato, K.; Iwata,
H.; Ohta, M.; Kurosumi,
M., and Tsugawa, K. (Reprint available from: Noguchi M Kanazawa
Univ Hosp, Operat Ctr Takara Machi 13-1 Kanazawa Ishikawa 9208641
Japan).. Breast Cancer Research & Treatment. 63(1):31-40, 2000
Sep. In process
Sentinel-node
biopsy sampling in breast cancer. Nieweg, O. E.; Tanis, P. J.; Olmos, R. A. V.; Rutgers, E. J.
T., and Kroon, B. B. R. (Reprint available from: Nieweg OE Netherlands
Canc Inst, Antoni Van Leeuwenhoek Hosp, Dept Surg Plesmanlaan 121
NL-1066 CX Amsterdam Netherlands).. Lancet. 356(9243): 1770, 2000
Nov 18. In process
Increased
false negative sentinel node biopsy rates after preoperative chemotherapy
for invasive breast carcinoma Nason,
K. S.; Anderson, B. O.; Byrd, D. R.; Dunnwald, L. K.; Eary, J. F.;
Mankoff, D. A.; Livingston, R.; Schmidt, R. A.; Jewell, K. D.; Yeung,
R. S., and Moe, R. E.. Cancer. 89(11):2187-2194, 2000 Dec 1. In
process
Pathologic
analysis of sentinel lymph nodes in breast carcinoma. Liberman,
L. (Reprint available from: Liberman L Mem Sloan Kettering Canc
Ctr, Dept Radiol, Breast Imaging Sect 1275 York Ave New York, NY
10021 USA). Cancer. 88(5):971-977, 2000 Mar 1. No abstract
Long-term
morbidity following axillary dissection in breast cancer patients
- clinical assessment, significance for life quality and the impact
of demographic, oncologic and therapeutic factors. Kuehn,
T.; Klauss, W.; Darsow, M.; Regele, S.; Flock, F.; Maiterth, C.;
Dahlbender, R.; Wendt, I., and Kreienberg, R. Breast Cancer Research
& Treatment. 64(3):275-286, 2000 Dec.
Sentinel
lymph node biopsy: Is it indicated in patients with high-risk ductal
carcinoma-in-situ and ductal carcinoma-in-situ with microinvasion? Klauber-DeMore, N.; Tan, L. K.; Liberman, L.; Kaptain, S.; Fey,
J.; Borgen, P.; Heerdt, A.; Montgomery, L.; Paglia, M.; Petrek,
J. A.; Cody, H. S., and Van Zee, K. J. Annals of Surgical Oncology.
7(9):636-642, 2000 Oct. In process
Pilot
study on sentinel node biopsy in breast cancer - Commentary Greene, F. L. (Reprint available from: Greene FL Carolinas Med
Ctr, Dept Gen Surg Charlotte, NC 28203 USA).. Journal of Surgical
Oncology. 73(3):133, 2000 Mar.
Impact
of sentinel lymph node mapping on relative charge in patients with
early-stage breast cancer. Gemignani, M. L.; Cody, H. S.; Fey, J. V.; Tran, K. N.; Venkatraman,
E., and Borgen, P. I. Annals of Surgical Oncology. 7(8):575-580,
2000 Sep. In process
Does
sentinel lymphadenectomy improve staging and alter therapy in elderly
women with breast cancer? DiFronzo, L. A.; Hansen, N. M.; Stern, S. L.; Brennan, M. B.,
and Giuliano, A. E. Annals of Surgical Oncology. 7(6):406-410, 2000
Jul. In process
A
high number of tumor free axillary lymph nodes from patients with
lymph node negative breast is associated with poor outcome. Cody, H. S. and Van Zee, K. J. (Reprint available from: Cody
HS Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol 1275 York Ave
New York, NY 10021 USA).. Cancer. 89(1):218, 2000 Jul 1. No abstract
Challenging
the myth of exercise-induced lymphedema following breast cancer:
A series of case reports Commentary.
(Reprint available from: Cady B Brown Univ, Women & Infants
Hosp, Breast Hlth Ctr Providence, RI 02908 USA).. Journal of Surgical
Oncology. 74(2):98-99, 2000 Jun. No abstract
Should
irradiation replace dissection for patients with breast cancer with
clinically negative axillary lymph nodes? Recht, A. (Reprint available from: Recht A Beth Israel Deaconess
Med Ctr, Dept Radiat Oncol East Campus,Finard Bldg B25,330 Brookline
Ave Boston, MA 02215 USA). Journal of Surgical Oncology. 72(4):184-192,
1999 Dec. No abstract
Lymphedema:
Current issues in research and management. Petrek,
J. A.; Pressman, P. I., and Smith, R. A. Ca: a Cancer Journal for
Clinicians. 50(5):292-307, 2000 Sep-Oct.