期刊
AMERICAN JOURNAL OF SURGERY
卷 213, 期 1, 页码 171-180出版社
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2016.04.019
关键词
Sentinel lymph node biopsy; Ductal carcinoma in situ; Breast cancer
类别
资金
- Breast Cancer Hope Foundation (London, UK)
BACKGROUND: Recent discussion has suggested that some cases of ductal carcinoma in situ (DCIS) with high risk of invasive disease may require sentinel lymph node biopsy (SLNB). METHODS: Systematic literature review identified 48 studies (9,803 DCIS patients who underwent SLNB). Separate analyses for patients diagnosed preoperatively by core sampling and patients diagnosed postoperatively by specimen pathology were conducted to determine the percentage of patients with axillary nodal involvement. Patient factors were analyzed for associations with risk of nodal involvement. RESULTS: The mean percentage of positive SLNBs was higher in the preoperative group (5.95% vs 3.02%; P=.0201). Meta-regression analysis showed a direct association with tumor size (P=.0333) and grade (P=.00839) but not median age nor tumor upstage rate. CONCLUSIONS: The SLNB should be routinely considered in patients with large (>2 cm) high-grade DCIS after a careful multidisciplinary discussion. In the context of breast conserving surgery, the SLNB is not routinely indicated for low- and intermediate-grade DCIS, high-grade DCIS smaller than 2 cm, or pure DCIS diagnosed by definitive surgical excision. Crown Copyright (C) 2016 Published by Elsevier Inc. All rights reserved.
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