Journal of the American College of Surgeons
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The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial concluded that axillary lymph node dissection (ALND) may not be necessary for all patients with sentinel lymph node (SLN) metastasis undergoing breast-conserving therapy (BCT). The aim of this study was to assess applicability of Z0011 results to our patient population and determine what percentage may be affected by these results. ⋯ Examination of our breast cancer patients with Z0011 trial criteria suggests that almost 75% of SLN-positive patients would be candidates to avoid ALND if they undergo BCT.
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Appendiceal perforation (AP) is a marker of health care disparities. We propose that racial disparities in children, as measured by AP, may change according to the type of hospital in which a child receives care. ⋯ These results underscore differential patterns of AP at the hospital level and deserve immediate attention because they may reflect far larger disparities in access and quality of care for children in California. Future interventions aimed at eliminating racial disparities in children must account for racial differences in access to timely diagnostic and surgical intervention for rapidly progressive and preventable clinical conditions such as AP.