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Sentinel Lymph Node Biopsy in Pure DCIS: Is It Necessary?
D E Boler1, N Cabioglu, U Ince
1Department of Surgery, Faculty of Medicine, Acıbadem University, Maltepe, 34848 Istanbul, Turkey.
ISRN Surgery
|June 6, 2012
Summary
Sentinel lymph node biopsy (SLNB) in pure ductal carcinoma in situ (DCIS) showed a 5% metastasis rate in our series. Factors like larger tumor size and higher grade indicate potential benefit from SLNB for DCIS patients.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Sentinel lymph node biopsy (SLNB) is debated in pure ductal carcinoma in situ (DCIS) due to low axillary metastasis rates.
- Identifying predictive factors for SLNB positivity in DCIS is crucial for patient selection.
Purpose of the Study:
- To identify patient and tumor characteristics associated with sentinel lymph node metastases in pure DCIS.
- To evaluate the utility of SLNB in a selected cohort of pure DCIS patients.
Main Methods:
- Retrospective review of 63 pure DCIS patients between July 2000 and March 2011.
- Detailed examination of sentinel lymph nodes (SLNs) using serial sectioning and cytokeratin immunostaining.
- Univariate and multivariate analyses to identify factors predicting SLNB positivity.
Main Results:
- Of 63 patients, 40 underwent SLNB, with 2 (5%) positive cases.
- SLNB positivity was associated with tumor size >30 mm, intermediate/high nuclear grade DCIS, and mastectomy.
- In positive cases, only one SLN was involved.
Conclusions:
- The observed 5% SLNB positivity rate in pure DCIS is higher than previously reported.
- Meticulous SLN examination techniques and specific patient selection criteria may contribute to this finding.
- Factors such as tumor size, nuclear grade, and mastectomy influence SLNB positivity in pure DCIS.
