title: Meta-analysis of sentinel node biopsy in ductal carcinoma in situ of the breast.
abstract: BACKGROUND
  The need for sentinel lymph node (SLN) biopsy in patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS) is debated. Advocates recommend such biopsy based on a high incidence of SLN involvement in some series. Opponents discourage SLN biopsy based on a perceived low incidence of nodal involvement in this setting. These contradictory arguments are generally based on small studies. The present study is a meta-analysis of the reported data on the incidence of SLN metastasis in patients with DCIS.
  
  
  METHODS
  A search of electronic databases identified studies reporting the frequency of SLN metastases in DCIS. The random-effects method was used to combine data.
  
  
  RESULTS
  Twenty-two published series were included in the meta-analysis. The estimate for the incidence of SLN metastases in patients with a preoperative diagnosis of DCIS was 7.4 (95 per cent confidence interval (c.i.) 6.2 to 8.9) per cent compared with 3.7 (95 per cent c.i. 2.8 to 4.8) per cent in patients with a definitive (postoperative) diagnosis of DCIS alone. This was a significant difference with an odds ratio of 2.11 (95 per cent c.i. 1.15 to 2.93).
  
  
  CONCLUSIONS
  Patients with a preoperative diagnosis of DCIS should be considered for SLN biopsy.
authors.affiliation: Department of Surgery and Molecular Oncology, Ninewells Hospital, Dundee University, Dundee, UK. bijan.ansari@nhs.net
authors.forename: B
authors.initials: B
authors.lastname: Ansari
authors.forename: S A
authors.initials: SA
authors.lastname: Ogston
authors.forename: C A
authors.initials: CA
authors.lastname: Purdie
authors.forename: D J
authors.initials: DJ
authors.lastname: Adamson
authors.forename: D C
authors.initials: DC
authors.lastname: Brown
authors.forename: A M
authors.initials: AM
authors.lastname: Thompson
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000556:secondary; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*