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Extent of Microinvasion in Ductal Carcinoma In Situ is not Associated with Sentinel Lymph Node Metastases

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Ductal carcinoma in situ with microinvasion (DCISM) is a rare diagnosis with a good prognosis. Although nodal metastases are uncommon, sentinel lymph node biopsy (SLNB) remains standard care. Volume of disease in invasive breast cancer is associated with SLNB positivity, and, thus we hypothesized that in a large cohort of patients with DCISM, multiple foci of microinvasion might be associated with a higher risk of positive SLNB.

Methods

Records from a prospective institutional database were reviewed to identify patients with DCISM who underwent SLNB between June 1997 and December 2010. Pathology reports were reviewed for number of microinvasive foci and categorized as 1 focus or ≥2 foci. Demographic, pathologic, treatment, and outcome data were obtained and analyzed.

Results

Of 414 patients, 235 (57 %) had 1 focus of microinvasion and 179 (43 %) had ≥2 foci. SLNB macrometastases were found in 1.4 %, and micrometastases were found in 6.3 %; neither were significantly different between patients with 1 focus versus ≥2 foci (p = 1.0). Patients with positive SLNB or ≥2 foci of microinvasion were more likely to receive chemotherapy. At median 4.9 years (range 0–16.2 years) follow-up, 18 patients, all in the SLNB negative group, had recurred for an overall 5-year recurrence-free proportion of 95.9 %.

Conclusions

Even with large numbers, there was no higher risk of nodal involvement with ≥2 foci of microinvasion compared with 1 focus. Number of microinvasive foci and results of SLNB appear to be used in decision making for systemic therapy. Prognosis is excellent.

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Acknowledgement

This study was presented in poster format at the 2014 American Society of Breast Surgeons 15th Annual Meeting and was funded in part through NIH/NCI Cancer Center Support Grant P30 CA008748.

Disclosure

The authors have no disclosures to report.

Author information

Authors and Affiliations

  1. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Cindy B. Matsen MD, Allison Hirsch BA, Michelle Stempel MPH, Alexandra Heerdt MD, Kimberly J. Van Zee MD, Hiram S. Cody III MD, Monica Morrow MD & George Plitas MD

  2. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Anne Eaton MS

Authors
  1. Cindy B. Matsen MD
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  2. Allison Hirsch BA
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  3. Anne Eaton MS
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  4. Michelle Stempel MPH
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  5. Alexandra Heerdt MD
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  6. Kimberly J. Van Zee MD
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  7. Hiram S. Cody III MD
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  8. Monica Morrow MD
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  9. George Plitas MD
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Correspondence to George Plitas MD.

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Matsen, C.B., Hirsch, A., Eaton, A. et al. Extent of Microinvasion in Ductal Carcinoma In Situ is not Associated with Sentinel Lymph Node Metastases. Ann Surg Oncol 21, 3330–3335 (2014). https://doi.org/10.1245/s10434-014-3920-2

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  • DOI: https://doi.org/10.1245/s10434-014-3920-2

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