Sentinel lymph node biopsy is not necessary in patients diagnosed with ductal carcinoma in situ of the breast by stereotactic vacuum-assisted biopsy

Autor: N Gondou, Akiyo Yoshimura, Mari Ichikawa, Naoto Kondou, Haruru Kotani, Tomoka Hisada, Yayoi Adachi, Masataka Sawaki, Junko Ishiguro, Takashi Fujita, Hiroji Iwata, Masaya Hattori
Rok vydání: 2014
Předmět:
Image-Guided Biopsy
medicine.medical_specialty
Vacuum
Sentinel lymph node
Breast Neoplasms
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Breast cancer
Biopsy
medicine
Humans
Neoplasm Invasiveness
Pharmacology (medical)
Radiology
Nuclear Medicine and imaging
skin and connective tissue diseases
Lymph node
Neoplasm Staging
Retrospective Studies
medicine.diagnostic_test
Sentinel Lymph Node Biopsy
business.industry
Carcinoma
Ductal
Breast
Cancer
General Medicine
Ductal carcinoma
Prognosis
medicine.disease
Surgery
body regions
Carcinoma
Intraductal
Noninfiltrating
medicine.anatomical_structure
Oncology
Lymphatic Metastasis
030220 oncology & carcinogenesis
Vacuum-Assisted Biopsy
Female
Lymph Nodes
Radiology
Neoplasm Grading
business
Follow-Up Studies
Calcification
Zdroj: Breast Cancer. 23:190-194
ISSN: 1880-4233
1340-6868
DOI: 10.1007/s12282-014-0546-y
Popis: This study evaluated the role and need of a sentinel lymph node biopsy (SLNB) in patients with an initial diagnosis of ductal carcinoma in situ (DCIS) made by stereotactic vacuum-assisted biopsy (VAB). A retrospective analysis was performed of 1,458 patients who underwent stereotactic VAB between January 1999 and December 2012 at Aichi Cancer Center Hospital. The rates of axillary node metastasis and the underestimation of invasive ductal carcinoma (IDC) were examined. Of the 1,458 patients who underwent stereotactic VAB, 199 had a preoperative diagnosis of DCIS and underwent surgery. In these patients, 20 % (39/199) were upstaged to IDC or at least microinvasion in final pathology. Axillary lymph node status was investigated in 81 % (161/199) of initially diagnosed DCIS patients, and resulted in finding lymph node metastasis in 0.62 % (1/161) patients. To assess the potential preoperative predictors of invasiveness, the value of DCIS histological grade on biopsy samples, the distribution of calcifications on mammograms, and the combination of these factors were studied. The underestimation rate was higher (30 %) in the combination of high DCIS histological grade and extensive calcification although there was no significant association (p = 0.23). The rate of lymph node metastasis was extremely low (0.62 %), even when invasive carcinoma was identified on excision in patients initially diagnosed with DCIS by stereotactic VAB. Because of the low prevalence of metastatic involvement, the cessation of SLNB is a reasonable consideration in patients initially diagnosed with DCIS by stereotactic VAB.
Databáze: OpenAIRE
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