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Do not contemplate invasive surgery for ductal carcinoma in situ
John J Zelis1, Brenda J Sickle-Santanello, Wen C Liang
1Department of Surgery, Grant Medical Center, Columbus, OH 43215, USA.
Background:
Ductal carcinoma in-situ (DCIS), by definition, has no metastatic potential. The routine examination of axillary lymph nodes in these patients may expose them to unnecessary operative morbidity and is the subject of continuing controversy. This study evaluates the lymph node status of patients with DCIS.
Methods:
A retrospective review of all tumor registry patients diagnosed with DCIS between January 1996 and December 2000 was performed. Data obtained included (1) patient demographics, (2) the surgical procedure performed, (3) the histologic grade of the tumor, and (4) the lymph node status, if obtained. All analysis was by hematoxylin and eosin (H&E) stain only.
Results:
In all, 380 patients were diagnosed with DCIS. Surgical therapy for these patients varied from lumpectomy (with negative margins) to modified radical mastectomy. Ninety-seven (25.5%) had their axillary lymph nodes (average 9, range 1 to 33) analyzed by H&E stain and are the subject of this study. One patient (1%) was found to have a lymph node micrometastasis.
Conclusions:
This study demonstrates that axillary lymph node examination is a low-yield endeavor for patients diagnosed with DCIS, regardless of the histologic grade of the tumor. Routine sampling of lymph nodes in these patients is not warranted.