The Controversial Role of Sentinel Node Biopsy in Ductal Carcinoma in Situ Diagnosed by Core-Biopsy or Mammotomy

Abstract

INTRODUCTION: Sentinel node biopsy (SNB) is a standard procedure used for the axillary approach in early stage invasive carcinomas (IC). When a patient is diagnosed with ductal carcinoma in situ (DCIS) by percutaneous biopsy, there is a variable chance of finding IC on final pathology, and it has been reported some risk factors for that, like palpable nodules, high grade tumors and the presence of comedonecrosis. The objective of this study was to investigate the role of SNB in cases of DCIS diagnosed by percutaneous biopsies. METHOD: We studied 81 patients with DCIS in preoperative percutaneous biopsy (core-biopsy or mammotomy) who underwent breast segmental resection from January 2006 to June 2012 for treatment. Among them, 71 had axillary lymph nodes excision (66 SNB and 5 full axillary dissection). RESULTS: Five patients (7%) presented at least one axillary node showing metastatic involvement. So far, it is possible to say that in at least 7% of the patients there was occult invasive foci in the samples of tissues obtained by percutaneous biopsies and diagnosed as DCIS. CONCLUSION: Sentinel lymph node involvement was found in a small percentage of patients with DCIS diagnosed by percutaneous biopsy (7%). The indication of SNB in these cases should be tailored to each case, also considering the presence of risk factors for occult local invasion.