Risk of Invasion and Axillary Lymph Node Metastasis in Ductal Carcinoma in Situ Diagnosed by Core-needle Biopsy.
From: Department of Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
The British journal of surgery
- Publish Date: Aug 2007
- ISSN: 0007-1323
- Volume: 94
- Issue: 8
- Pages: 952-6
- Medium: Print
- Language: English
- Citation (JAMA): Meijnen P, Oldenburg H S A, Loo C E, et al. Risk of Invasion and Axillary Lymph Node Metastasis in Ductal Carcinoma in Situ Diagnosed by Core-needle Biopsy.. Aug 2007;94:952-6
Abstract
BACKGROUND: The aim of the study was to assess the risk of invasion and axillary lymph node metastasis in patients with ductal carcinoma in situ (DCIS) diagnosed by preoperative core-needle biopsy. The data were used to select criteria for patients in whom sentinel node (SN) biopsy might be indicated. METHODS: One hundred and seventy-one women with 172 DCIS lesions diagnosed by core-needle biopsy were analysed. Axillary staging was performed by SN biopsy, axillary node sampling, or level 1-2 axillary lymph node dissection. RESULTS: Invasive breast cancer was found in the surgical specimens from 45 tumours (26.2 per cent). Risk factors for invasion were a palpable lesion (odds ratio (OR) 2.95 (95 per cent confidence interval 1.20 to 7.26); P = 0.019), presence of a mass on mammography (OR 3.06 (1.43 to 6.56); P = 0.004), and intermediate (OR 5.81 (1.18 to 28.57); P = 0.030) or poorly differentiated (OR 5.46 (1.17 to 25.64); P = 0.031) tumour grade. Lymph node metastases were found in ten women with DCIS and invasion on final pathology. Factors associated with metastases were age 55 years or less (P = 0.030), invasion of 1.0 cm or more (P < 0.001) and the presence of vascular invasion (P = 0.001). CONCLUSION: SN biopsy should be considered in women with an initial diagnosis of DCIS on core-needle biopsy who are at risk for invasion; this includes women with a palpable lump, a mass on mammography, and intermediate or poor tumour grade.
Mesh Headings (Keywords): Adult, Aged, Analysis of Variance, Axilla, Biopsy, Needle, Breast, Breast Neoplasms, Carcinoma in Situ, Carcinoma, Ductal, Breast, Female, Humans, Lymph Node Excision, Lymphatic Metastasis, Mastectomy, Segmental, Middle Aged, Neoplasm Invasiveness, Risk Factors
Check for Full Text / PubMed Unique Identifier (PMID): 17440955
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