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Sentinel Node Biopsies Rising, But Not Everyone Gets Them

Less-invasive breast cancer staging procedure used less often in minorities, poor, uninsured

WEDNESDAY, March 26 (HealthDay News) -- The use of sentinel lymph node biopsy -- an alternative to axillary lymph node dissection -- increased during a recent period in women with early-stage breast cancer, but a number of racial, socioeconomic and other factors were associated with a lower likelihood of having the procedure, according to research published in the April 2 issue of the Journal of the National Cancer Institute.

Amy Y. Chen, M.D., of Emory University in Atlanta, and colleagues analyzed data from the National Cancer Database on nearly 500,000 women diagnosed with stage I and II breast cancer from 1998 through 2005.

The use of sentinel lymph node biopsy rose from 26.8 percent to 65.5 percent over this period, the researchers report. Factors significantly associated with lower odds of undergoing sentinel lymph node biopsy (which is a less-invasive alternative) include older age, racial/ethnic minority status, lack of health insurance, receiving Medicaid or Medicare before the age of 65, and living in an area with lower median income, the report indicates.

"Such [racial and ethnic, socioeconomic and health insurance] disparities are seen in all aspects of cancer care. Given America's track record of disparate care, I suppose we should not be surprised that racial and ethnic minorities were disproportionately deprived of another medical advance. However, this observation is profoundly disappointing and sobering. It is yet another call for us to redouble efforts to identify and correct the root causes of disparities," writes Stephen B. Edge, M.D., of the Roswell Park Cancer Institute in Buffalo, N.Y., in an accompanying editorial.

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