An update of sentinel lymph node mapping in patients with ductal carcinoma in situ

Objective: The purpose of our study is to further clarify the incidence of ductal carcinoma in situ (DCIS) patients that are upstaged upon final pathology and/or have metastatic disease in the axilla. Methods: All patients were diagnosed with DCIS or DCIS with micro invasion (DCISm) on their diagnostic biopsy and received a sentinel lymph node (SLN) biopsy between 1994 and 2004. Six hundred seventy-five patients were divided into 613 patients with DCIS and 62 patients with DCISm. Results: Sixty-six of 675 (10%) were upstaged to invasive cancer. Fifty-five of 613 (9%) patients with DCIS were upstaged, whereas 11 of 62 (18%) patients with DCISm were upstaged. Forty-nine of 675 (7%) patients had +SLN. Twenty-two of 49 (45%) patients with +SLN had invasive carcinoma or DCISm on final histology. Conclusions: After review of histology; grade, type of biopsy, and mammographic findings, the combined findings of high grade, mass by mammography, and microinvasion/predict patients at higher risk for invasive carcinoma. Selective utilization of SLN biopsy in DCIS is recommended. (c) 2005 Excerpta Medica Inc. All rights reserved.