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- Title
Is Sentinel Lymph Node Dissection Necessary in All Patients with Ductal Carcinoma In Situ Undergoing Total Mastectomy?
- Authors
BONEV, VALENTINA; DE PAZ VILLANUEVA, CARLOS CHAVEZ; SOLOMON, NAVEENRAJ; SENTHIL, MAHESWARI; REEVES, MARK E.; GARBEROGLIO, CARLOS; LUM, SHARON S.
- Abstract
When ductal carcinoma in situ (DCIS) is found on core needle biopsy, rates of upgrade to invasive cancer of 25 per cent and nodal positivity of 10 per cent have been reported. Sentinel lymph node dissection (SLND) is recommended when mastectomy is performed for DCIS. We investigated the role of SLND in DCIS patients undergoing partial and total mastectomy (TM). During the study period 2004 to 2013, 170 patients with DCIS were identified with a median age of 60 years (range 26-84 years). Of these, 58.2 per cent had partial mastectomy (PM) alone, 10.6 per cent had PM with SLND, and 31.1 per cent had TM with or without contralateral prophylactic mastectomy with SLND. Overall, SLND identified positive nodes in 4.2 per cent of patients. Upgrade to invasive carcinoma on final breast pathology was found in 8.2 per cent of patients overall, including 4.0 per cent of patients undergoing PM alone, 22.2 per cent undergoing PM with SLND, and 11.3 per cent for TM with SLND (P = 0.8). In this study, patients diagnosed with DCIS on core needle biopsy had lower than expected rates of positive sentinel nodes and upgrade to invasive carcinoma. Surgeons and patients should revisit the necessity of SLND in DCIS patients undergoing mastectomy, which could lead to decreased health expenditure, resources, time, morbidity, and emotional impact on patients.
- Subjects
DUCTAL carcinoma; BREAST cancer surgery; MASTECTOMY complications; SENTINEL lymph node biopsy; LYMPHADENECTOMY; THERAPEUTICS; ACADEMIC medical centers; ADENOCARCINOMA; BREAST tumors; CANCER invasiveness; COMPARATIVE studies; LONGITUDINAL method; MASTECTOMY; RESEARCH methodology; MEDICAL cooperation; NEEDLE biopsy; PROGNOSIS; RESEARCH; RISK assessment; SURVIVAL analysis (Biometry); TIME; TUMOR classification; EVALUATION research; RETROSPECTIVE studies
- Publication
American Surgeon, 2016, Vol 82, Issue 10, p982
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481608201027