ABSTRACT
La biopsia de ganglio centinela (BGC) ha demostrado ser una alternativa segura a la linfadenectomía axilar en la estadificación del cáncer de mama. El equipo multidisciplinar debe realizarlo con rigor y demostrando cumplir unos criterios esenciales. Objetivo. Evaluar la calidad del procedimiento en la Unidad de Patología Mamaria del Hospital Puerta del Mar, utilizando la guía de autoevaluación de la Sociedad Española de Senología y Patología Mamaria. Material y método. Dicha guía establece unos criterios de evaluación objetivos y medibles en los aspectos que intervienen en la BGC. Cada criterio se asocia a 4 niveles de estándares de calidad. Existen 3 criterios esenciales de obligado cumplimiento para implementar la BSCG en la práctica clínica. Se evalúan: experiencia asistencial (6 criterios), aspectos operativos (18 criterios, 3 esenciales) y actividad científica (8 indicadores). Material y método. La fase de validación incluyó 50 pacientes y la fase de aplicación 120 pacientes hasta febrero de 2009. Resultados. Se cumplen los 3 criterios esenciales relacionados con la detección del ganglio centinela (98%), sensibilidad acreditada (90%), promedio de ganglios axilares centinelas (2,1). Resultados. La aplicación de la guía de autoevaluación ha resultado una puntuación global de 39 sobre 71 puntos. Siendo el nivel II el nivel de calidad más prevalente. Conclusión. Nuestra Unidad cumplió durante la validación los criterios establecidos para implementar la técnica. Tras ella, la utilización de la guía acredita la buena práctica del procedimiento de BGC y permite identificar las áreas de mejora, en nuestro caso las relacionadas con actividades científicas y formativas de la Unidad(AU)
The Sentinel Lymph Node Biopsy (SLNB) has been demonstrated to be a safe alternative to axillary lymph node dissection in breast cancer staging. The multidisciplinary team must do it with rigor and demonstrate that they have fulfilled some essential criteria. Objective. To evaluate the quality of the procedure in the Breast Pathology Unit of Hospital Puerta del Mar, using the self-evaluation guidelines of the Spanish Society of Senology and Breast Pathology. Material and method. These guidelines establish some objective and measurable evaluation criteria related to the aspects that intervene in the SLNB. Each criterion is associated to 4 levels of quality standards. There are 3 essential criteria of mandatory fulfillment to implement SLNB in the clinical practice. They evaluate care experience (6 criteria), operative aspects (18 criteria, 3 essential) and scientific activity (8 indicators). The initial validation phase included 50 patients and the application phase 120 patients (February 2009). Results. Three essential criteria related to the detection of the sentinel node (98%), accredited sensitivity (90%), and mean number of axillary sentinel nodes (2.1) were fulfilled. The application of self-evaluation guidelines in our Unit obtained a global score of 39 out of 71 points, quality level II being the most prevalent. Conclusion. During the validation phase, our unit fulfilled the criteria established to implement the procedure. Following that, the use of this guideline accredits the good practice of the SLNB procedure and makes it possible to identify the areas of improvement, in our case, those related to the scientific and training activities(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/surgery , Sentinel Lymph Node Biopsy/methods , Sentinel Lymph Node Biopsy , Quality Indicators, Health Care/trends , Quality Indicators, Health Care , Reference Standards , /trends , Quality Control , Self-Evaluation Programs/trends , Indicators of Morbidity and MortalityABSTRACT
UNLABELLED: The Sentinel Lymph Node Biopsy (SLNB) has been demonstrated to be a safe alternative to axillary lymph node dissection in breast cancer staging. The multidisciplinary team must do it with rigor and demonstrate that they have fulfilled some essential criteria. OBJECTIVE: To evaluate the quality of the procedure in the Breast Pathology Unit of Hospital Puerta del Mar, using the self-evaluation guidelines of the Spanish Society of Senology and Breast Pathology. MATERIAL AND METHOD: These guidelines establish some objective and measurable evaluation criteria related to the aspects that intervene in the SLNB. Each criterion is associated to 4 levels of quality standards. There are 3 essential criteria of mandatory fulfillment to implement SLNB in the clinical practice. They evaluate care experience (6 criteria), operative aspects (18 criteria, 3 essential) and scientific activity (8 indicators). The initial validation phase included 50 patients and the application phase 120 patients (February 2009). RESULTS: Three essential criteria related to the detection of the sentinel node (98%), accredited sensitivity (90%), and mean number of axillary sentinel nodes (2.1) were fulfilled. The application of self-evaluation guidelines in our Unit obtained a global score of 39 out of 71 points, quality level II being the most prevalent. CONCLUSION: During the validation phase, our unit fulfilled the criteria established to implement the procedure. Following that, the use of this guideline accredits the good practice of the SLNB procedure and makes it possible to identify the areas of improvement, in our case, those related to the scientific and training activities.