title: [Sentinel lymph node metastasis in patients with ductal breast carcinoma in situ].
abstract: BACKGROUND
  Sentinel lymph node biopsy in patients with ductal carcinoma in situ still controversial, with positive lymph node in range of 1.4-12.5% due occult invasive breast carcinoma in surgical specimen.
  
  
  OBJECTIVE
  To know the frequency of sentimel node metastases in patients with ductal carcinoma in situ, identify differences between positive and negative cases.
  
  
  METHODS
  Retrospective study of patients with ductal carcinoma in situ treated with sentinel lymph node biopsy because mastectomy indication, palpable tumor, radiological lesion = 5 cm, non-favorable breast-tumor relation and/or patients whom surgery could affect lymphatic flow drainage.
  
  
  RESULTS
  Of 168 in situ carcinomas, 50 cases with ductal carcinoma in situ and sentinel lymph node biopsy were included, with a mean age of 51.6 years, 30 (60%) asymptomatic. The most common symptoms were palpable nodule (18%), nipple discharge (12%), or both (8%). Microcalcifications were common (72%), comedonecrosis pattern (62%), grade-2 histology (44%), and 28% negative hormonal receptors. Four (8%) cases had intra-operatory positive sentinel lymph node and one patient at final histo-pathological study (60% micrometastases, 40% macrometastases), all with invasive carcinoma in surgical specimen. Patients with intra-operatory positive sentinel lymph node where younger (44.5 vs 51 years), with more palpable tumors (50% vs 23.1%), and bigger (3.5 vs 2 cm), more comedonecrosis pattern (75% vs 60.8%), more indifferent tumors (75% vs 39.1%), and less cases with hormonal receptors (50% vs 73.9%), compared with negative sentinel lymph node cases, all these differences without statistic significance.
  
  
  CONCLUSIONS
  One of each 12 patients with ductal carcinoma in situ had affection in sentinel lymph node, so we recommend continue doing this procedure to avoid second surgeries due the presence of occult invasive carcinoma.
authors.affiliation: Departamento de Oncología Mamaria Quirúrgica, Instituto de Enfermedades de la Mama (IEM) de la Fundación del Cáncer de Mama, A. C. (FUCAM), México DF, Mexico.
authors.forename: Eva
authors.initials: E
authors.lastname: Ruvalcaba-Limón
authors.affiliation: Departamento de Oncología Mamaria Quirúrgica, Instituto de Enfermedades de la Mama (IEM) de la Fundación del Cáncer de Mama, A. C. (FUCAM), México DF, Mexico.
authors.forename: María
authors.initials: M
authors.lastname: de Jesús Garduño-Raya
authors.affiliation: Departamento de Patología, Instituto de Enfermedades de la Mama (IEM) de la Fundación del Cáncer de Mama, A. C. (FUCAM), México DF, Mexico.
authors.forename: Verónica
authors.initials: V
authors.lastname: Bautista-Piña
authors.affiliation: Departamento de Medicina Nuclear, Instituto de Enfermedades de la Mama (IEM) de la Fundación del Cáncer de Mama, A. C. (FUCAM), México DF, Mexico.
authors.forename: Claudia
authors.initials: C
authors.lastname: Trejo-Martínez
authors.affiliation: Departamento de Oncología Mamaria Quirúrgica, Instituto de Enfermedades de la Mama (IEM) de la Fundación del Cáncer de Mama, A. C. (FUCAM), México DF, Mexico.
authors.forename: Antonio
authors.initials: A
authors.lastname: Maffuz-Aziz
authors.affiliation: Departamento de Oncología Mamaria Quirúrgica, Instituto de Enfermedades de la Mama (IEM) de la Fundación del Cáncer de Mama, A. C. (FUCAM), México DF, Mexico.
authors.forename: Sergio
authors.initials: S
authors.lastname: Rodríguez-Cuevas
mesh_terms: D000328:Adult; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D002114:Calcinosis / Q000000981:diagnostic imaging; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000556:secondary*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000556:secondary; D004967:Estrogens; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008327:Mammography; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009376:Neoplasms, Hormone-Dependent / Q000175:diagnosis / Q000556:secondary; D055966:Nipple Aspirate Fluid; D011374:Progesterone; D017584:Reproductive History; D021701:Sentinel Lymph Node Biopsy
chemical_list: D004967:Estrogens; D011374:Progesterone
keywords: Ductal carcinoma in situ; biopsia; breast  cancer; carcinoma ductal; cáncer de mama; ganglio centinela; sentinel lymph node biopsy