Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer.
BACKGROUND
The impact of sentinel lymph node biopsy on breast cancer mimicking ductal carcinoma in situ (DCIS) is a matter of debate.


METHODS
We studied the rate of occurrence of sentinel lymph node metastasis in 255 breast cancer patients with pure DCIS showing no invasive components on routine pathological examination. We compared this to the rate of occurrence in 177 patients with predominant intraductal-component (IDC) breast cancers containing invasive foci equal to or less than 0.5 cm in size.


RESULTS
Most of the clinical and pathological baseline characteristics were the same between the two groups. However, peritumoral lymphatic permeation occurred less often in the pure DCIS group than in the IDC-predominant invasive-lesion group (1.2% vs. 6.8%, p = 0.002). One patient (0.39%) with pure DCIS had two sentinel lymph nodes positive for metastasis. This rate was significantly lower than that in patients with IDC-predominant invasive lesions (6.2%; p < 0.001).


CONCLUSIONS
Because the rate of sentinel lymph node metastasis in pure DCIS is very low, sentinel lymph node biopsy can safely be omitted.
Tada
Keiichiro
K
Department of Breast Surgery, Cancer Institute Hospital, Tokyo, Japan. ktada@jfcr.or.jp
Ogiya
Akiko
A
Kimura
Kiyomi
K
Morizono
Hidetomo
H
Iijima
Kotaro
K
Miyagi
Yumi
Y
Nishimura
Seiichiro
S
Makita
Masujiro
M
Horii
Rie
R
Akiyama
Futoshi
F
Iwase
Takuji
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000556:secondary*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000556:secondary*; D005260:Female; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy