Nattinger et al observed an increasing trend of inappropriate treatment of early stage breast cancer in the SEER database, mainly due to an increased proportion of patients receiving breast-conserving therapy and the higher likelihood of inappropriate breast-conserving therapy (omission of ALND, radiotherapy or both) compared to MRM; 19% of the patients treated in 1995 received incomplete treatment ( Nattinger et al , 2000 ).
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Guideline adherence for early breast cancer before and after introduction of the sentinel node biopsy.
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