Axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast

Research output: Contribution to journalArticle

Abstract

Hypothesis: A sentinel lymph node (SLN) biopsy should not be considered a standard procedure in the treatment of all patients with ductal carcinoma in situ (DCIS) of the breast if the lesion is completely excised by radical surgery and there are free margins of resection. Design: Prospective case series. Setting: Department of breast surgery of a comprehensive cancer center. Patients: From January 1, 1998, to December 1, 2001, 223 unselected consecutive patients affected by pure DCIS of the breast underwent an SLN biopsy. Results: Metastases in the SLN were detected in 7 (3.1%) of the 223 patients, and complete axillary dissection was subsequently performed in all these patients but 1. Of these 7 patients, 5 had only micrometastases in the SLNs; and in the 6 patients treated with complete axillary dissection, the SLN was the only positive node. Conclusions: Because of the low prevalence of metastases, an SLN biopsy should not be considered a standard procedure in all patients with DCIS. In patients with pure DCIS in whom the lesion is completely excised by radical surgery, an SLN biopsy could be avoided. It could be considered in patients with DCIS undergoing mastectomy, in whom there exists a higher risk of harboring an invasive component using definitive histologic features, like large solid tumors or diffuse or multicentric microcalcifications; in these patients, an SLN biopsy cannot be performed at a later operation. Complete axillary dissection may not be mandatory if the SLN is micrometastatic.

Original languageEnglish
Pages (from-to)309-313
Number of pages5
JournalArchives of Surgery
Volume138
Issue number3
DOIs
Publication statusPublished - Mar 1 2003

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Sentinel Lymph Node Biopsy
Carcinoma, Intraductal, Noninfiltrating
Breast
Dissection
Neoplasm Metastasis
Calcinosis
Neoplasm Micrometastasis
Mastectomy
Free Radicals
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

@article{a1d6db59d3b34aa6a89a3c686f24f426,
title = "Axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast",
abstract = "Hypothesis: A sentinel lymph node (SLN) biopsy should not be considered a standard procedure in the treatment of all patients with ductal carcinoma in situ (DCIS) of the breast if the lesion is completely excised by radical surgery and there are free margins of resection. Design: Prospective case series. Setting: Department of breast surgery of a comprehensive cancer center. Patients: From January 1, 1998, to December 1, 2001, 223 unselected consecutive patients affected by pure DCIS of the breast underwent an SLN biopsy. Results: Metastases in the SLN were detected in 7 (3.1{\%}) of the 223 patients, and complete axillary dissection was subsequently performed in all these patients but 1. Of these 7 patients, 5 had only micrometastases in the SLNs; and in the 6 patients treated with complete axillary dissection, the SLN was the only positive node. Conclusions: Because of the low prevalence of metastases, an SLN biopsy should not be considered a standard procedure in all patients with DCIS. In patients with pure DCIS in whom the lesion is completely excised by radical surgery, an SLN biopsy could be avoided. It could be considered in patients with DCIS undergoing mastectomy, in whom there exists a higher risk of harboring an invasive component using definitive histologic features, like large solid tumors or diffuse or multicentric microcalcifications; in these patients, an SLN biopsy cannot be performed at a later operation. Complete axillary dissection may not be mandatory if the SLN is micrometastatic.",
author = "Mattia Intra and Paolo Veronesi and Giovanni Mazzarol and Viviana Galimberti and Alberto Luini and Virgilio Sacchini and Giuseppe Trifir{\`o} and Oreste Gentilini and Giancarlo Pruneri and Paola Naninato and Fabio Torres and Giovanni Paganelli and Giuseppe Viale and Umberto Veronesi",
year = "2003",
month = "3",
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doi = "10.1001/archsurg.138.3.309",
language = "English",
volume = "138",
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T1 - Axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast

AU - Intra, Mattia

AU - Veronesi, Paolo

AU - Mazzarol, Giovanni

AU - Galimberti, Viviana

AU - Luini, Alberto

AU - Sacchini, Virgilio

AU - Trifirò, Giuseppe

AU - Gentilini, Oreste

AU - Pruneri, Giancarlo

AU - Naninato, Paola

AU - Torres, Fabio

AU - Paganelli, Giovanni

AU - Viale, Giuseppe

AU - Veronesi, Umberto

PY - 2003/3/1

Y1 - 2003/3/1

N2 - Hypothesis: A sentinel lymph node (SLN) biopsy should not be considered a standard procedure in the treatment of all patients with ductal carcinoma in situ (DCIS) of the breast if the lesion is completely excised by radical surgery and there are free margins of resection. Design: Prospective case series. Setting: Department of breast surgery of a comprehensive cancer center. Patients: From January 1, 1998, to December 1, 2001, 223 unselected consecutive patients affected by pure DCIS of the breast underwent an SLN biopsy. Results: Metastases in the SLN were detected in 7 (3.1%) of the 223 patients, and complete axillary dissection was subsequently performed in all these patients but 1. Of these 7 patients, 5 had only micrometastases in the SLNs; and in the 6 patients treated with complete axillary dissection, the SLN was the only positive node. Conclusions: Because of the low prevalence of metastases, an SLN biopsy should not be considered a standard procedure in all patients with DCIS. In patients with pure DCIS in whom the lesion is completely excised by radical surgery, an SLN biopsy could be avoided. It could be considered in patients with DCIS undergoing mastectomy, in whom there exists a higher risk of harboring an invasive component using definitive histologic features, like large solid tumors or diffuse or multicentric microcalcifications; in these patients, an SLN biopsy cannot be performed at a later operation. Complete axillary dissection may not be mandatory if the SLN is micrometastatic.

AB - Hypothesis: A sentinel lymph node (SLN) biopsy should not be considered a standard procedure in the treatment of all patients with ductal carcinoma in situ (DCIS) of the breast if the lesion is completely excised by radical surgery and there are free margins of resection. Design: Prospective case series. Setting: Department of breast surgery of a comprehensive cancer center. Patients: From January 1, 1998, to December 1, 2001, 223 unselected consecutive patients affected by pure DCIS of the breast underwent an SLN biopsy. Results: Metastases in the SLN were detected in 7 (3.1%) of the 223 patients, and complete axillary dissection was subsequently performed in all these patients but 1. Of these 7 patients, 5 had only micrometastases in the SLNs; and in the 6 patients treated with complete axillary dissection, the SLN was the only positive node. Conclusions: Because of the low prevalence of metastases, an SLN biopsy should not be considered a standard procedure in all patients with DCIS. In patients with pure DCIS in whom the lesion is completely excised by radical surgery, an SLN biopsy could be avoided. It could be considered in patients with DCIS undergoing mastectomy, in whom there exists a higher risk of harboring an invasive component using definitive histologic features, like large solid tumors or diffuse or multicentric microcalcifications; in these patients, an SLN biopsy cannot be performed at a later operation. Complete axillary dissection may not be mandatory if the SLN is micrometastatic.

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DO - 10.1001/archsurg.138.3.309

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JO - Archives of Surgery

JF - Archives of Surgery

SN - 0004-0010

IS - 3

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