The purpose of this study was to determine the rates of sentinel lymph node (SLN) positivity in patients with a final diagnosis of ductal carcinoma in situ (DCIS) or microinvasive breast cancer (MIC).
One hundred thirty patients underwent SLN mapping from 1998 to 2003 for DCIS or MIC.
One hundred nine patients with DCIS and 21 with MIC underwent SLN mapping. One patient with bilateral DCIS underwent 2 SLN procedures; therefore, the results of 131 SLN procedures are included. On hematoxylin and eosin (H&E) staining, 4 of 110 patients (3.6%) with DCIS had positive SLNs. Four additional patients had positive SLNs by IHC staining only (3.6%). Two of 8 patients underwent completion axillary dissection, and neither had additional involved nodes on completion axillary dissection. One of the 21 patients with MIC had positive SLNs by hematoxylin and eosin (H&E) (4.8%), and another had an involved SLN by IHC staining (4.8%). The patient with the positive SLN by H&E had 1 additional node on completion axillary dissection.
Rates of SLN positivity for patients with DCIS are modest, even in a high-risk population, and there is continuing uncertainty about its clinical importance.
"102 1% Lee Moffitt Cancer Center, FL, USA  195 13%: 6.5% by H&E; 6.5% by IHC Lee Moffitt Cancer Center, FL, USA  559 5%: 1.5% by H&E, 3.5% by IHC University of Paris, France  110 6% Sibley Memorial Hospital, Washington DC, USA  110 7.2%: 3.6% by H&E; 3.6% by IHC Memorial Sloan Kettering Cancer Center  76 12% Acibadem University, Faculty of Medicine, Istanbul (present study) 40 5%: 2.5% by H&E, 2.5% by IHC The variation in SLN positivity may be attributed to evolution of sentinel node biopsy techniques, different preoperative diagnostic methods, variations in pathological examination including extent of tissue sampling and evaluation of the SLNs with H&E or IHC or both, and small patient numbers in some series  . Some reports doubled their node positivity frequencies by using IHC to detect SLN involvement   . In a study by Lata et al. , in 13% of the patients, SLNs were shown to be involved by tumor cells by IHC methods but no significant association with local, regional or distant recurrence was shown. "
[Show abstract][Hide abstract] ABSTRACT: Introduction. Sentinel lymph node biopsy (SLNB) in patients with pure ductal carcinoma in situ (DCIS) has been a matter of debate due to very low rate of axillary metastases. We therefore aimed to identify factors in a single institutional series to select patients who may benefit from SLNB.
Material and Methods. Patients, diagnosed with pure DCIS (n = 63) between July 2000 and March 2011, were reviewed. All the sentinel lymph nodes were examined by serial sectioning (50 μm) of the entire lymph node and H&E staining, and by cytokeratin immunostaining in suspicious cases. Results. Median age was 51 (range, 30–79). Of 63 patients, 40 cases (63.5%) with pure DCIS underwent SLN, and 2 of them had a positive SLN (5%). In both 2 cases with SLN metastases, only one sentinel lymph node was involved with tumor cells. Patients who underwent SLNB were more likely to have a tumor size >30 mm or DCIS with intermediate and high nuclear grade or a mastectomy in univariate and multivariate analyses. Conclusion. In our series, we found a slightly higher rate of SLNB positivity in patients with pure DCIS than the large series reported elsewhere. This may either be due to the meticulous examination of SLNs by serial sectioning technique or due to our patient selection criteria or both.
[Show abstract][Hide abstract] ABSTRACT: Oncological surgery of the breast has undergone changes from several aspects in the past 20 years. The primary reason has
been the introduction of a biological approach, cancer screening, development of the surgical technique and the daily use
of quality assurance principles. We are again witnessing a paradigm change, the essence of which is that maximal radical treatment
is being replaced by minimal but sufficient surgical intervention. However, surgery remains determinant in the treatment of
KeywordsEarly breast cancer-Surgery
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