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Related Experiment Video

Updated: May 19, 2026

The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
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The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy

Published on: June 1, 2019

Refining Sentinel Lymph Node Biopsy Decisions for Clinically Node-Negative Microinvasive DCIS.

Cien Huang1, Priyanka Parmar2, Noor Habboosh2

  • 1Albert Einstein College of Medicine, Bronx, New York, New York, USA, yu.edu.

The Breast Journal
|May 18, 2026
PubMed
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This summary is machine-generated.

Ductal carcinoma in situ with microinvasion (DCISM) patients without a palpable mass or mammographic abnormality have a low risk of invasive cancer and lymph node involvement. These findings suggest that sentinel lymph node biopsy (SLNB) may be safely omitted in select low-risk DCISM cases.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Radiology

Background:

  • Ductal carcinoma in situ with microinvasion (DCISM) is diagnosed in 5%-10% of DCIS cases, with debate on its management as DCIS or invasive cancer.
  • Minimizing treatment morbidity drives efforts to identify low-risk DCISM patients who may avoid axillary surgery, including sentinel lymph node biopsy (SLNB).
  • Limited data exists on the axillary management of DCISM, necessitating identification of preoperative predictors for upstaging to invasive carcinoma.

Purpose of the Study:

  • To identify preoperative predictors of upstaging to invasive carcinoma in clinically node-negative patients with DCISM.
  • To guide the use of sentinel lymph node biopsy (SLNB) in DCISM management.
  • To enable risk stratification and de-escalation of axillary surgery for DCISM.

Main Methods:

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  • Retrospective chart review of women aged ≥19 years with confirmed or suspected DCISM on initial biopsy, who were clinically node-negative.
  • Data collected from 2013 to 2023 at a tertiary center.
  • Fisher's exact test, Student's t-test, and univariate/multivariate analyses were used to identify predictors of upstaging.

Main Results:

  • Of 61 women with DCISM, 40.9% were upstaged to invasive carcinoma.
  • Preoperative predictors of upstaging included palpable mass (OR 9.0, p=0.003), mammographic mass (OR 12.86, p=0.02), and mass with calcifications (OR 13.34, p=0.047).
  • Among upstaged patients, 12.5% had positive lymph nodes on SLNB.

Conclusions:

  • Clinically node-negative DCISM patients without a palpable or mammographic mass have a low risk of upstaging and lymph node involvement.
  • These patients may safely forgo SLNB, allowing for de-escalation of axillary surgery.
  • Further prospective studies are needed to refine guidelines for DCISM management.