Omission of sentinel lymph node biopsy in breast cancer: a survey of Brazilian breast surgeons

■ De-escalation of axillary surgery has become a priority in breast cancer treatment.
■ Factors associated with the decision to omit sentinel lymph node biopsy were collected via questionnaire.
■ Sentinel lymph node biopsy was omitted more often by private doctors and those holding a doctoral degree.
■ Continuing medical education initiatives are needed to update other groups.

ABSTRACT

Objective:

Considering the increasing number of new breast cancer cases and the morbidity associated with axillary lymph node dissection in breast cancer treatment, this study evaluated the factors related to the omission of sentinel lymph node biopsy in early-stage breast cancer.

Methods:

A cross-sectional, observational, descriptive study was conducted using a digital questionnaire. Breast surgeons and physicians from other specialties currently practicing in Brazil were included. Data were tabulated and analyzed using Microsoft Office Excel®, version 2023. Statistical analyses were performed using JASP 0.19.1 software. Descriptive analysis was performed by calculating the absolute (n) and relative (%) frequencies of qualitative variables. Logistic regression analysis was performed using the stepwise method, and highly correlated variables were removed for the construction of the final model.

Results:

Of the 274 physicians, 158 (57.7%) reported omitting sentinel lymph node biopsy. Medical residency in surgical oncology, achievement of a specialist degree in mastology (TEMA – Título de Especialista em Mastologia, é a especialidade mencionada), time of practice in the specialty, sphere of professional practice, holding a Master’s degree, and holding a doctoral degree were selected for multivariate analysis based on p-values and their greater clinical relevance. In the final logistic regression, statistical significance was observed for sphere of professional practice and holding a doctoral degree.