Top

Published in:

Open Access 01-12-2010 | Research

Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer

Authors: Keiichiro Tada, Akiko Ogiya, Kiyomi Kimura, Hidetomo Morizono, Kotaro Iijima, Yumi Miyagi, Seiichiro Nishimura, Masujiro Makita, Rie Horii, Futoshi Akiyama, Takuji Iwase

Published in: World Journal of Surgical Oncology | Issue 1/2010

Abstract

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.

Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, Feldman S, Kusminsky R, Gadd M, Kuhn J, Harlow S, Beitsch P: The sentinel node in breast cancer--a multicenter validation study. N Engl J Med. 1998, 339: 941-946. 10.1056/NEJM199810013391401.CrossRefPubMed

Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Robertson C, Maisonneuve P, Renne G, De Cicco C, De Lucia F, Gennari R: A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003, 349: 546-553. 10.1056/NEJMoa012782.CrossRefPubMed

Kim T, Giuliano AE, Lyman GH: Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a metaanalysis. Cancer. 2006, 106: 4-16. 10.1002/cncr.21568.CrossRefPubMed

Barone JE, Tucker JB, Perez JM, Odom SR, Ghevariya V: Evidence-based medicine applied to sentinel lymph node biopsy in patients with breast cancer. Am Surg. 2005, 71: 66-70.PubMed

Lucci A, McCall LM, Beitsch PD, Whitworth PW, Reintgen DS, Blumencranz PW, Leitch AM, Saha S, Hunt KK, Giuliano AE: Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. J Clin Oncol. 2007, 25: 3657-3663. 10.1200/JCO.2006.07.4062.CrossRefPubMed

Zavagno G, De Salvo GL, Scalco G, Bozza F, Barutta L, Del Bianco P, Renier M, Racano C, Carraro P, Nitti D: A Randomized clinical trial on sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer: results of the Sentinella/GIVOM trial. Ann Surg. 2008, 247: 207-213. 10.1097/SLA.0b013e31812e6a73.CrossRefPubMed

Burstein HJ, Polyak K, Wong JS, Lester SC, Kaelin CM: Ductal carcinoma in situ of the breast. N Engl J Med. 2004, 350: 1430-1441. 10.1056/NEJMra031301.CrossRefPubMed

Ansari B, Ogston SA, Purdie CA, Adamson DJ, Brown DC, Thompson AM: Meta-analysis of sentinel node biopsy in ductal carcinoma in situ of the breast. Br J Surg. 2008, 95: 547-554. 10.1002/bjs.6162.CrossRefPubMed

Moore KH, Sweeney KJ, Wilson ME, Goldberg JI, Buchanan CL, Tan LK, Liberman L, Turner RR, Lagios MD, Cody Iii HS, Giuliano AE, Silverstein MJ, Van Zee KJ: Outcomes for women with ductal carcinoma-in-situ and a positive sentinel node: a multi-institutional audit. Ann Surg Oncol. 2007, 14: 2911-2917.CrossRefPubMed

10.

Intra M, Rotmensz N, Veronesi P, Colleoni M, Iodice S, Paganelli G, Viale G, Veronesi U: Sentinel node biopsy is not a standard procedure in ductal carcinoma in situ of the breast: the experience of the European institute of oncology on 854 patients in 10 years. Ann Surg. 2008, 247: 315-319. 10.1097/SLA.0b013e31815b446b.CrossRefPubMed

11.

Zavagno G, Carcoforo P, Marconato R, Franchini Z, Scalco G, Burelli P, Pietrarota P, Lise M, Mencarelli R, Capitanio G, Ballarin A, Pierobon ME, Marconato G, Nitti D: Role of axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast. BMC Cancer. 2005, 5: 28-10.1186/1471-2407-5-28.PubMedCentralCrossRefPubMed

12.

Tada K, Nishimura S, Miyagi Y, Takahashi K, Makita M, Iwase T, Yoshimoto M, Kasumi F, Koizumi M: The effect of an old surgical scar on sentinel node mapping in patients with breast cancer: a report of five cases. Eur J Surg Oncol. 2005, 31: 840-844. 10.1016/j.ejso.2005.05.005.CrossRefPubMed

13.

Londero V, Zuiani C, Furlan A, Nori J, Bazzocchi M: Role of ultrasound and sonographically guided core biopsy in the diagnostic evaluation of ductal carcinoma in situ (DCIS) of the breast. Radiol Med. 2007, 112: 863-876. 10.1007/s11547-007-0183-z.CrossRefPubMed

14.

Polom K, Murawa D, Wasiewicz J, Nowakowski W, Murawa P: The role of sentinel node biopsy in ductal carcinoma in situ of the breast. Eur J Surg Oncol. 2009, 35: 43-47.CrossRefPubMed

15.

Fortunato L, Santoni M, Drago S, Gucciardo G, Farina M, Cesarini C, Cabassi A, Tirelli C, Terribile D, Grassi GB, De Fazio S, Vitelli CE, Rome Breast Cancer Study Group: Sentinel lymph node biopsy in women with pT1a or "microinvasive" breast cancer. Breast. 2008, 17: 395-400. 10.1016/j.breast.2008.03.003.CrossRefPubMed

16.

Zavagno G, Belardinelli V, Marconato R, Carcoforo P, Franchini Z, Scalco G, Burelli P, Pietrarota P, Mencarelli R, Marconato G, Nitti D: Sentinel lymph node metastasis from mammary ductal carcinoma in situ with microinvasion. Breast. 2007, 16: 146-151. 10.1016/j.breast.2006.08.002.CrossRefPubMed

17.

Burak WE, Hollenbeck ST, Zervos EE, Hock KL, Kemp LC, Young DC: Sentinel lymph node biopsy results in less postoperative morbidity compared with axillary lymph node dissection for breast cancer. Am J Surg. 2002, 183: 23-27. 10.1016/S0002-9610(01)00848-0.CrossRefPubMed

18.

Youngson BJ, Liberman L, Rosen PP: Displacement of carcinomatous epithelium in surgical breast specimens following stereotaxic core biopsy. Am J Clin Pathol. 1995, 103: 598-602.PubMed

19.

Diaz LK, Wiley EL, Venta LA: Are malignant cells displaced by large-gauge needle core biopsy of the breast?. AJR Am J Roentgenol. 1999, 173: 1303-1313.CrossRefPubMed

20.

Bleiweiss IJ, Nagi CS, Jaffer S: Axillary sentinel lymph nodes can be falsely positive due to iatrogenic displacement and transport of benign epithelial cells in patients with breast carcinoma. J Clin Oncol. 2006, 24: 2013-2018. 10.1200/JCO.2005.04.7076.CrossRefPubMed

21.

Fitzal F, Sporn EP, Draxler W, Mittlbock M, Taucher S, Rudas M, Riedl O, Helbich TH, Jakesz R, Gnant M: Preoperative core needle biopsy does not increase local recurrence rate in breast cancer patients. Breast Cancer Res Treat. 2006, 97: 9-15. 10.1007/s10549-005-6935-3.CrossRefPubMed

22.

Peters-Engl C, Konstantiniuk P, Tausch C, Haid A, Hoffmann B, Jagoutz-Herzlinger M, Kugler F, Redtenbacher S, Roka S, Schrenk P, Steinmassl D: The impact of preoperative breast biopsy on the risk of sentinel lymph node metastases: analysis of 2502 cases from the Austrian Sentinel Node Biopsy Study Group. Br J Cancer. 2004, 91: 1782-1786. 10.1038/sj.bjc.6602205.PubMedCentralCrossRefPubMed

23.

Broekhuizen LN, Wijsman JH, Peterse JL, Rutgers EJ: The incidence and significance of micrometastases in lymph nodes of patients with ductal carcinoma in situ and T1a carcinoma of the breast. Eur J Surg Oncol. 2006, 32: 502-506. 10.1016/j.ejso.2006.02.006.CrossRefPubMed

24.

de Boer M, van Deurzen CH, van Dijck JA, Borm GF, van Diest PJ, Adang EM, Nortier JW, Rutgers EJ, Seynaeve C, Menke-Pluymers MB, Bult P, Tjan-Heijnen VC: Micrometastases or isolated tumor cells and the outcome of breast cancer. N Engl J Med. 2009, 361: 653-663. 10.1056/NEJMoa0904832.CrossRefPubMed

Title: Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer
Authors: Keiichiro Tada
Akiko Ogiya
Kiyomi Kimura
Hidetomo Morizono
Kotaro Iijima
Yumi Miyagi
Seiichiro Nishimura
Masujiro Makita
Rie Horii
Futoshi Akiyama
Takuji Iwase
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2010
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/1477-7819-8-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2010

Retroperitoneal lymph node dissection for residual masses after chemotherapyin nonseminomatous germ cell testicular tumor

Non-polypoidal, synchronous mantle- cell lymphoma of small intestine: a rare case

Mixed germ cell tumor metastatic to the skin: Case report and literature review

Carcinoma ex pleomorphic adenoma of soft palate with cavernous sinus invasion

Perforated mixed carcinoid-adenocarcinoma in transverse colon and at gastroenterostomy site: case report

Haemostatics in surgery and our experience in the enucleoresection of renal cell carcinoma