Annals of Surgical Oncology

, Volume 7, Issue 9, pp 636–642

Sentinel Lymph Node Biopsy: Is It Indicated in Patients With High-Risk Ductal Carcinoma-In-Situ and Ductal Carcinoma-In-Situ With Microinvasion?

  • Nancy Klauber-DeMore
  • Lee K. Tan
  • Laura Liberman
  • Stamatina Kaptain
  • Jane Fey
  • Patrick Borgen
  • Alexandra Heerdt
  • Leslie Montgomery
  • Michael Paglia
  • Jeanne A. Petrek
  • Hiram S. CodyIII
  • Kimberly J. Van Zee
Original Article

Abstract

Background: Axillary lymph node status is the strongest prognostic indicator of survival for women with breast cancer. The purpose of this study was to determine the incidence of sentinel node metastases in patients with high-risk ductal carcinoma-in-situ (DCIS) and DCIS with microinvasion (DCISM).

Methods: From November 1997 to November 1999, all patients who underwent sentinel node biopsy for high-risk DCIS (n = 76) or DCISM (n = 31) were enrolled prospectively in our database. Patients with DCIS were considered high risk and were selected for sentinel lymph node biopsy if there was concern that an invasive component would be identified in the specimen obtained during the definitive surgery. Patients underwent intraoperative mapping that used both blue dye and radionuclide. Excised sentinel nodes were serially sectioned and were examined by hematoxylin and eosin and by immunohistochemistry.

Results: Of 76 patients with high-risk DCIS, 9 (12%) had positive sentinel nodes; 7 of 9 patients were positive for micrometastases only. Of 31 patients with DCISM, 3 (10%) had positive sentinel nodes; 2 of 3 were positive for micrometastases only. Six of nine patients with DCIS and three of three with DCISM and positive sentinel nodes had completion axillary dissection; one patient with DCIS had an additional positive node detected by conventional histological analysis.

Conclusions: This study documents a high incidence of lymph node micrometastases as detected by sentinel node biopsy in patients with high-risk DCIS and DCISM. Although the biological significance of breast cancer micrometastases remains unclear at this time, these findings suggest that sentinel node biopsy should be considered in patients with high-risk DCIS and DCISM.

Key Words

Breast carcinoma Ductal carcinoma-in-situ Microinvasion Sentinel lymph node biopsy Intraductal carcinoma Micrometastases 

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Copyright information

© The Society of Surgical Oncology, Inc. 2000

Authors and Affiliations

  • Nancy Klauber-DeMore
    • 1
  • Lee K. Tan
    • 2
  • Laura Liberman
    • 3
  • Stamatina Kaptain
    • 2
  • Jane Fey
    • 1
  • Patrick Borgen
    • 1
  • Alexandra Heerdt
    • 1
  • Leslie Montgomery
    • 1
  • Michael Paglia
    • 1
  • Jeanne A. Petrek
    • 1
  • Hiram S. CodyIII
    • 1
  • Kimberly J. Van Zee
    • 1
    • 4
  1. 1.Departments of SurgeryMemorial Sloan-Kettering Cancer CenterNew York
  2. 2.PathologyMemorial Sloan-Kettering Cancer CenterNew York
  3. 3.RadiologyMemorial Sloan-Kettering Cancer CenterNew York
  4. 4.Memorial Sloan-Kettering Cancer CenterNew York

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