Indication for sentinel lymph node biopsy for breast cancer when core biopsy shows ductal carcinoma in situ

Am J Surg. 2011 Jul;202(1):59-65. doi: 10.1016/j.amjsurg.2010.09.032.

Abstract

Background: The use of sentinel lymph node biopsy (SLNB) for ductal carcinoma in situ (DCIS) is controversial.

Methods: A total of 103 primary breast cancer patients who were diagnosed with DCIS by needle biopsy preoperatively and underwent initial SLNB were analyzed retrospectively.

Results: No sentinel nodal metastasis was detected in 66 patients with the final diagnosis of DCIS. However, 2 (5.4%) of 37 patients with invasive ductal carcinoma at final diagnosis had positive sentinel nodes. Multivariate logistic regression analysis identified 2 independent significant predictors of existence of invasive components: presence of a palpable tumor (odds ratio, 4.091; 95% confidential interval, 1.399-11.959; P = .010) and tumor size of 2.0 cm or larger on magnetic resonance imaging (odds ratio, 4.506; 95% confidence interval, 1.322-15.358; P = .016).

Conclusions: Initial SLNB should be considered for patients diagnosed with DCIS by needle biopsy when they have a high risk for harboring invasive ductal cancer preoperatively.

MeSH terms

  • Adult
  • Aged
  • Biopsy, Fine-Needle
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / surgery
  • Female
  • Humans
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy*
  • Young Adult