Sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion: Retrospective observational study

With the introduction of an organized mammographic screening, the incidence of ductal carcinoma in situ (DCIS) has experienced an important increase. Our experience with sentinel lymph node biopsy (SLNB) among patients with DCIS is reviewed. We collected retrospective data on patients operated on th...

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Autores principales: Bertozzi, Serena, Cedolini, Carla, Londero, Ambrogio P., Baita, Barbara, Giacomuzzi, Francesco, Capobianco, Decio, Tortelli, Marta, Uzzau, Alessandro, Mariuzzi, Laura, Risaliti, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344146/
https://www.ncbi.nlm.nih.gov/pubmed/30608397
http://dx.doi.org/10.1097/MD.0000000000013831
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author Bertozzi, Serena
Cedolini, Carla
Londero, Ambrogio P.
Baita, Barbara
Giacomuzzi, Francesco
Capobianco, Decio
Tortelli, Marta
Uzzau, Alessandro
Mariuzzi, Laura
Risaliti, Andrea
author_facet Bertozzi, Serena
Cedolini, Carla
Londero, Ambrogio P.
Baita, Barbara
Giacomuzzi, Francesco
Capobianco, Decio
Tortelli, Marta
Uzzau, Alessandro
Mariuzzi, Laura
Risaliti, Andrea
author_sort Bertozzi, Serena
collection PubMed
description With the introduction of an organized mammographic screening, the incidence of ductal carcinoma in situ (DCIS) has experienced an important increase. Our experience with sentinel lymph node biopsy (SLNB) among patients with DCIS is reviewed. We collected retrospective data on patients operated on their breasts for DCIS (pTis), DCIS with microinvasion (DCISM) (pT1mi) and invasive ductal carcinoma (IDC) sized ≤2 cm (pT1) between January 2002 and June 2016, focusing on the result of SLNB. 543 DCIS, 84 DCISM, and 2111 IDC were included. In cases of DCIS and DCISM, SLNB resulted micrometastatic respectively in 1.7% and 6.0% of cases and macrometastatic respectively in 0.9% and 3.6% of cases. 5-year disease-free survival and overall survival in DCISM and IDC were similar, while significantly longer in DCIS. 5-year local recurrence rate of DCIS and DCISM were respectively 2.5% and 7.9%, and their 5-year distant recurrence rate respectively 0% and 4%. IDC, tumor grading ≥2 and lymph node (LN) macrometastasis were significant predictors for decreased overall survival. Significant predictors for distant metastases were DCISM, IDC, macroscopic nodal metastasis, and tumor grading ≥2. Predictors for the microinvasive component in DCIS were tumor multifocality/multicentricity, grading ≥2, ITCs and micrometastases. Our study suggests that despite its rarity, sentinel node metastasis may also occur in case of DCIS, which in most cases are micrometastases. Even in the absence of an evident invasive component, microinvasion should always be suspected in these cases, and their management should be the same as for IDC.
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spelling pubmed-63441462019-02-04 Sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion: Retrospective observational study Bertozzi, Serena Cedolini, Carla Londero, Ambrogio P. Baita, Barbara Giacomuzzi, Francesco Capobianco, Decio Tortelli, Marta Uzzau, Alessandro Mariuzzi, Laura Risaliti, Andrea Medicine (Baltimore) Research Article With the introduction of an organized mammographic screening, the incidence of ductal carcinoma in situ (DCIS) has experienced an important increase. Our experience with sentinel lymph node biopsy (SLNB) among patients with DCIS is reviewed. We collected retrospective data on patients operated on their breasts for DCIS (pTis), DCIS with microinvasion (DCISM) (pT1mi) and invasive ductal carcinoma (IDC) sized ≤2 cm (pT1) between January 2002 and June 2016, focusing on the result of SLNB. 543 DCIS, 84 DCISM, and 2111 IDC were included. In cases of DCIS and DCISM, SLNB resulted micrometastatic respectively in 1.7% and 6.0% of cases and macrometastatic respectively in 0.9% and 3.6% of cases. 5-year disease-free survival and overall survival in DCISM and IDC were similar, while significantly longer in DCIS. 5-year local recurrence rate of DCIS and DCISM were respectively 2.5% and 7.9%, and their 5-year distant recurrence rate respectively 0% and 4%. IDC, tumor grading ≥2 and lymph node (LN) macrometastasis were significant predictors for decreased overall survival. Significant predictors for distant metastases were DCISM, IDC, macroscopic nodal metastasis, and tumor grading ≥2. Predictors for the microinvasive component in DCIS were tumor multifocality/multicentricity, grading ≥2, ITCs and micrometastases. Our study suggests that despite its rarity, sentinel node metastasis may also occur in case of DCIS, which in most cases are micrometastases. Even in the absence of an evident invasive component, microinvasion should always be suspected in these cases, and their management should be the same as for IDC. Wolters Kluwer Health 2019-01-04 /pmc/articles/PMC6344146/ /pubmed/30608397 http://dx.doi.org/10.1097/MD.0000000000013831 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Bertozzi, Serena
Cedolini, Carla
Londero, Ambrogio P.
Baita, Barbara
Giacomuzzi, Francesco
Capobianco, Decio
Tortelli, Marta
Uzzau, Alessandro
Mariuzzi, Laura
Risaliti, Andrea
Sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion: Retrospective observational study
title Sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion: Retrospective observational study
title_full Sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion: Retrospective observational study
title_fullStr Sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion: Retrospective observational study
title_full_unstemmed Sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion: Retrospective observational study
title_short Sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion: Retrospective observational study
title_sort sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion: retrospective observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344146/
https://www.ncbi.nlm.nih.gov/pubmed/30608397
http://dx.doi.org/10.1097/MD.0000000000013831
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