for Jean, Robin P and all those who started with DCIS with microinvasion (recognized

[Lani]

or not)
2 November 2006
Sentinel node biopsy prudent in microinvasive DCIS
The risk–benefit balance favors performing sentinel lymph node (SLN) biopsy in all women with ductal carcinoma in situ with microinvasion (DCISM), Italian oncologists believe.

Giorgio Zavagno (University of Padova, Italy) and fellow researchers reviewed the outcomes of SLN in a series of patients with DCISM. They obtained data on 43 women with this a rare form of breast cancer who were treated at one of six institutions over a five-year period.

DCISM was diagnosed on the basis of one or more areas of invasion beyond the basal membrane, none exceeding 1 mm, Zavagno et al explain in their report, which appears in The Breast journal.

A total of 69 SLNs were excised, with positive results in four women (micrometastasis in one and macrometastases in three). All four women were subsequently found to have axillary macrometastases.

The authors say that DCISM "must be considered true invasive breast cancer" as it has a well-established potential to spread to the regional lymph nodes.

Nevertheless, the indications for axillary lymph node dissection in DCISM patients have always been controversial in view of the significant morbidity and low likelihood of finding positive nodes.

"The introduction of SLN biopsy has changed the terms of the problem," write Zavagno et al. "This procedure incurs low morbidity and allows a more thorough histologic examination, thus improving the probability of a positive nodal finding."

The authors conclude that, given the relative frequency of SLN metastases in this series, SLN biopsy should be performed when microinvasive foci are found at histology.



The Breast 2006; Advance online publication

http://www.journals.elsevierhealth.c...01640/abstract