![]() Although limited by a small sample size, our results suggest that SLNB should still be recommended to patients undergoing mastectomy for DCIS on core needle biopsy due to the high rate of upstage rate to invasive disease.īreast cancer ductal carcinoma in situ sentinel lymph node biopsy. However, a significant number of patients (36%) were upstaged due to invasive cancer. However, in certain cases (size >3 cm, high grade, mass effect on mammography, or palpable mass), it may be possible to find incidental invasive carcinoma (IC) that requires an SLNB. Only 3% of patients with DCIS undergoing mastectomy were found to have SLN metastases. Introduction: Sentinel lymph node biopsy (SLNB) in ductal carcinoma in situ (DCIS) is not indicated. Of the remaining 25 (64%) patients with DCIS on final pathology, 0 (0%) had SLNB positivity. Of those with DCIS on core biopsy, 14 (36%) were upstaged to invasive disease on final surgical pathology, including the patient with positive SLNB. One patient (3%) had positive nodes on SLNB and underwent axillary lymph node dissection. Although SLNB is typically a safe procedure, there are potential complications and associated costs. 70% were Caucasian, 18% were African American, 8% were Asian, and the remaining 5% were unknown. The role of sentinel lymph node biopsy (SLNB) for patients with ductal carcinoma in-situ (DCIS) is limited given the rarity of nodal metastasis in non-invasive disease. Introduction: NICE recommends a sentinel node biopsy (SNB) should not be performed for DCIS treated with breast conserving surgery (BCS) unless a patient is. Of 187 patients undergoing mastectomy with SLNB from 2012 to 2016 for DCIS or invasive ductal carcinoma, 39 (21%) were diagnosed with DCIS on core biopsy. Patient demographics, tumor characteristics, and pathologic variables were abstracted. Patients were included if core needle biopsy demonstrated DCIS. ![]() Patients undergoing mastectomy were identified from our institution's SLNB database from 2012 to 2016. ![]() ![]() In this study, we seek to determine the role of SLNB in patients undergoing mastectomy for the treatment of DCIS. In the modern era, there is a trend toward minimizing invasive staging and treatment of the axilla. All rights reserved.Current treatment guidelines for ductal carcinoma in situ (DCIS) treated with mastectomy recommend sentinel lymph node biopsy (SLNB). To optimise the axillary treatment of patients with DCIS, an improved compliance to the national DCIS guidelines is necessary.īreast-conserving surgery Ductal carcinoma in situ Mastectomy National cancer care guidelines Sentinel lymph node biopsy.Ĭopyright © 2017 Elsevier Ltd. Breast cancer guidelines advise sentinel lymph node biopsy (SLNB) in patients with ductal carcinoma in situ (DCIS) on core biopsy at high risk of invasive cancer or in case of mastectomy. The use of SLNB in patients with DCIS and adherence to the Danish national guidelines varies among Danish breast surgery departments. A significant difference in the use of SLNB with BCS and mastectomy according to department capacity (high-volume departments versus low-volume departments) was observed. The use of SLNB in combination with BCS differed significantly between departments ranging from 19.7% to 63.8%. The SLNB was performed in 23.8% of 454 patients not included by the guidelines. A sample of tissue from this node (biopsy) can reveal if cancer has spread there. ![]() The postoperative phase includes radiation, endocrine therapy, immunotherapy, and chemotherapy. Your doctor can identify the sentinel lymph node by injecting dye into the breast and seeing which node takes up the dye first: This is the sentinel. Sentinel lymph node biopsy is also performed when there is suspected nodal disease. A total of 1877 (71.7%) patients underwent breast-conserving surgery (BCS), and 577 (22.0%) underwent mastectomy, of which 43.9% and 86.0% respectively had a concomitant SLNB. The sentinel lymph node is where cancer from invasive ductal carcinoma is likely to show up first. The use of SLNB increased from 26.6% in 2004 to 65.1% in 2015. The chi-squared test was used to test differences between the groups.ĭata from 2618 Danish female patients diagnosed with DCIS between 20 were included 54.3% of patients underwent SLNB. The use of SLNB in DCIS patients according to year of diagnosis, age at diagnosis, size of lesion, Van Nuys classification, palpability, location and department of surgery was evaluated. In the present study, the use of SLNB in patients with DCIS was evaluated nationally and compared across Danish departments.Ī register-based study was conducted using the Danish Breast Cancer Group database. Thus, axillary staging with sentinel lymph node biopsy (SLNB) should only be used according to the current guidelines to avoid over-treatment and unnecessary morbidity. The risk of axillary metastases in breast cancer patients with only ductal carcinoma in situ (DCIS) is low. ![]()
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