Modifications of the learning curve guidelines for breast cancer sentinel node biopsy

Surgery and radiotherapy in vulvar cancer

“…However, a negative SLN in a breast cancer patient without lymph node metastases does not prove that the "true sentinel lymph node" has been removed. Therefore, further study on the learning curve was performed and showed that surgeons should focus on the number of cases with axillary lymph node metastases [88]. The false negative rate should be calculated in those patients.…”

A Comparison of Indocyanine Green Fluorescence Imaging Plus Blue Dye and Blue Dye Alone for Sentinel Node Navigation Surgery in Breast Cancer Patients

“…5 Moreover, a breast surgeon needs to experience a number of cases in the dye method until a satisfactory identification rate is obtained. [6][7][8] Recently, SNNS with invisible near-infrared fluorescence imaging (FI) has been introduced and is associated with highly sensitive results. 9,10 FI enables visualized and real-time lymphography; the combined use of FI is thus advantageous as compared with RI.…”

Locoregional therapy of breast cancer: maximizing control, minimizing morbidity

“…However, it is worth mentioning that the patients included in these series were of surgeons with considerable experience with SLN biopsy and after an appropriate learning curve where the SLN biopsy was followed by an immediate ALND to accurately determine the false-negative rate. It is recommended that no surgeon begin performing SLN biopsy without completion ALND unless they have documented an adequate number of cases (20-30) where a suitably low false-negative rate is verified on completion ALND [119][120][121][122]. However, many surgeons have adopted this technique without documenting an adequate learning curve, which may adversely affect the false-negative rate as SLN biopsy becomes universal.…”