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A concept for the clinical implementation of sentinel lymph node biopsy in patients with breast carcinoma with special regard to quality assurance†

  1. Thorsten Kuehn M.D.1,‡,*,
  2. Andreas Bembenek M.D.2,
  3. Thomas Decker M.D.3,
  4. Dieter Ludwig Munz M.D.4,
  5. Marie-Luise Sautter-Bihl M.D.5,
  6. Michael Untch M.D.6,
  7. Diethelm Wallwiener M.D.7,
  8. For the Consensus Committee of the German Society of Senology§

Article first published online: 20 DEC 2004

DOI: 10.1002/cncr.20786

Issue

Cancer

Cancer

Volume 103, Issue 3, pages 451–461, 1 February 2005

Additional Information

How to Cite

Kuehn, T., Bembenek, A., Decker, T., Munz, D. L., Sautter-Bihl, M.-L., Untch, M., Wallwiener, D. and For the Consensus Committee of the German Society of Senology (2005), A concept for the clinical implementation of sentinel lymph node biopsy in patients with breast carcinoma with special regard to quality assurance. Cancer, 103: 451–461. doi: 10.1002/cncr.20786

Author Information

  1. 1

    Department of Gynecology and Obstetrics, Interdisciplinary Breast Center, Gifhorn, Germany

  2. 2

    Department of Surgery and Surgical Oncology, Charite, Robert-Roessle-Klinik im HELIOS-Klinikum, Berlin, Germany

  3. 3

    Department of Pathology, Breast Unit, HELIOS-Klinikum Berlin, Berlin, Germany

  4. 4

    Clinic for Nuclear Medicine, Charite-Berlin University Medicine, Charite Campus Mitte, Berlin, Germany

  5. 5

    Department of Radiooncology, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany

  6. 6

    Department of Gynecology and Obstetrics, LMU München, München, Germany

  7. 7

    Department of Gynecology and Obstetrics, University of Tuebingen, Tuebingen, Germany

  1. ‡

    Fax: 011 (49) 5371871608

  2. §

    The consensus committee of the German Society of Senology was comprised of A. Bembenek (Department of Surgery and Surgical Oncology, Charite, Robert-Roessle-Klinik im HELIOS-Klinikum, Berlin), H. Buechels (Department of Plastic and Reconstructive Surgery, Klinikum Augsburg, Augsburg), T. Decker (Department of Pathology, Breast Unit, HELIOS-Klinikum, Berlin), J. Dunst (Department of Radiooncology, Martin-Luther-Universität Halle, Wittenberg), T. Kuehn (Department of Gynecology and Obstetrics, Interdisciplinary Breast Center, Gifhorn), U. Muellerleile (Department of Oncology, Krankenhaus Barmbeck, Hamburg), D. L. Munz (Clinic for Nuclear Medicine, Charite-Berlin University Medicine, Charite Campus Mitte and Charite Campus Virchow Klinikum, Berlin), H. Ostertag (Department of Gynecology and Obstetrics, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel); M. L. Sautter-Bihl (Department of Radiooncology, Städtisches Klinikum Karlsruhe, Karlsruhe), H. Schirrmeister (Department of Nuclear Medicine, University, Schleswig-Holstein, Campus Kiel, Kiel), A. H. Tulusan (Department of Gynecology, Klinikum Bayreuth, Bayreuth), M. Untch (Department of Gynecology and Obstetrics, LMU München, München), K. J. Winzer (Breast Center Charite, Berlin University Medecine, Campus Charite Mitte, Berlin), C. Wittekind (Institute of Pathology, University of Leipzig, Leipzig), and D. Wallwiener (Department of Gynecology and Obstetrics, University of Tuebingen, Tuebingen).

*Interdisziplinäres Brustzentrum, Frauenklinik, Bergstrsse 30, 38518 Gifhorn, Germany

  1. †

    See related editorial on pages 444–6, this issue.

Publication History

  1. Issue published online: 20 JAN 2005
  2. Article first published online: 20 DEC 2004
  3. Manuscript Accepted: 6 OCT 2004
  4. Manuscript Revised: 19 SEP 2004
  5. Manuscript Received: 15 JUL 2004

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Keywords:

  • breast carcinoma;
  • sentinel lymph node biopsy;
  • quality assurance;
  • consensus panel

Abstract

The development of standardized and reproducible clinical pathways is an important precondition for quality assurance in medicine, especially if a new method has not yet been ultimately validated. Sentinel lymph node biopsy (SLNB) is a widely accepted new surgical procedure in the treatment of early breast carcinoma. However, numerous steps of the method and details of the technique are not standardized and, thus, hamper quality assurance for SLNB. The German Society of Senology appointed an interdisciplinary consensus committee to work out guidelines for the standardized performance and quality-assured implementation of SLNB on a nationwide, homogeneous standard. The committee consisted of surgeons, gynecologists, radiooncologists, nuclear physicians, oncologists, and pathologists. Relevant questions related to patient selection, lymphatic mapping, surgery, histopathologic work-up, further local and systemic treatment decisions, patient information, training, and follow-up were evaluated with respect to clinical evidence, objectivity, and reproducibility. Clinical pathways were developed on the basis of this analysis. Requirements to the performing institutions and surgeons were defined. Cancer 2005. © 2004 American Cancer Society.

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