SUR2 Prevalence of teaching sentinel lymph node biopsy for breast cancer in general surgery residency programs. (Surgery).

SUR2 PREVALENCE OF TEACHING SENTINEL LYMPH NODE BIOPSY FOR BREAST CANCER IN GENERAL SURGERY RESIDENCY PROGRAMS. Kurt G. Davis, MD, and John P. Schriver, MD. William Beaumont Army Medical Center, El Paso, Tex.

The practice of performing sentinel lymph node biopsy (SLNB) for breast cancer has rapidly gained acceptance in the general surgery community since its introduction in 1994. Not since the introduction of laparoscopic cholecystectomy in the early 1990s has a surgical procedure that so radically alters traditional surgical dogma been embraced so quickly. The purpose of this study was to document the prevalence of teaching SLNB in general surgery residency programs. The Fellowship and Residency Electronic Interactive Database (FREIDA) was searched for a listing of all general surgery residency programs in the United States. A short questionnaire was mailed to the program director of each residency program listed. The program directors were asked about whether general surgery residents were taught the technique of performing SLNB for breast cancer, or whether there were plans to begin teaching it within the next academic year. They were asked whether they were performing SLNB as part of an organized protocol and whether an axillary dissection followed SLNB. In addition they were asked about their method of performing SLNB: with radioactive isotope, dye or both. Of the 255 surgical programs listed in FREIDA, 191 or 75% responded to the survey. 92% of responding programs are currently teaching surgical residents SLNB, while 4% plan on adding SLNB to the curriculum within the next academic year. 73% of programs are performing SLNB as part of an organized hospital protocol. 61% perform SLNB and base subsequent therapy on the SLN pathology, while 39% routinely follow SLNB with an axillary node dissection. 89% of the programs performing SLNB use both radioisotope and dye, while 7% use dye alone, and 4% use only radioisotope. The practice of performing SLNB for the purpose of detecting occult nodal metastases in breast cancer is being taught at the vast majority of surgery training programs in this country. In less than 6 years since the modification of this technique to the treatment of breast disease, it is becoming the s tandard of care for treating clinically node negative women with invasive breast cancer at teaching hospitals