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

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

Tadaetal.WorldJournalofSurgicalOncology2010,8:6 /content/8/1/6 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH OpenAccess Ductalcarcinomainsituandsentinellymph nodemetastasisinbreastcancer KeiichiroTada ,AkikoOgiya ,KiyomiKimura ,HidetomoMorizono,KotaroIijima ,YumiMiyagi1, 1* 2 1 1 1 SeiichiroNishimura ,MasujiroMakita ,RieHorii ,FutoshiAkiyama ,TakujiIwase1 1 1 2 2 Abstract Background:Theimpactofsentinellymphnodebiopsyonbreastcancermimickingductalcarcinomainsitu (DCIS)isamatterofdebate. Methods:Westudiedtherateofoccurrenceofsentinellymphnodemetastasisin255breastcancerpatientswith pureDCISshowingnoinvasivecomponentsonroutinepathologicalexamination.Wecomparedthistotherateof occurrencein177patientswithpredominantintraductal-component(IDC)breastcancerscontaininginvasivefoci equaltoorlessthan0.5cminsize. Results:Mostoftheclinicalandpathologicalbaselinecharacteristicswerethesamebetweenthetwogroups. However,peritumorallymphaticpermeationoccurredlessofteninthepureDCISgroupthanintheIDC- predominantinvasive-lesiongroup(1.2%vs.6.8%,p=0.002).Onepatient(0.39%)withpureDCIShadtwosentinel lymphnodespositiveformetastasis.ThisratewassignificantlylowerthanthatinpatientswithIDC-predominant invasivelesions(6.2%;p0.001). Conclusions:BecausetherateofsentinellymphnodemetastasisinpureDCISisverylow,sentinellymphnode biopsycansafelybeomitted. Introduction candidatesformetastasis,isfeasible.Inthesesituations, The technique of sentinel lymph node biopsy is used some investigators have argued that more than a few worldwide as a surgical treatment for breast cancer casesofpureDCISareaccompaniedbysentinel lymph [1,2]. This procedure can accurately determine lymph nodemetastasis, andtheindications forsentinel lymph nodemetastasis[3,4].Thereforemorbidaxillarydissec- nodebiopsy shouldbeextended notonlytocases with tion can be safely avoided when sentinel lymph nodes invasive cancer, but also to those with pure DCIS [9]. arefreefromcancer[5,6]. However, others have argued that the i