scholarly journals Long-Term Outcomes of Sentinel Lymph Node Biopsy for Ductal Carcinoma in Situ

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Peiyin Hung ◽  
Shi-Yi Wang ◽  
Brigid K Killelea ◽  
Sarah S Mougalian ◽  
Suzanne B Evans ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Cancer Mortality ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Long Term Outcomes ◽  
Node Biopsy

Abstract The use of sentinel lymph node biopsy (SLNB) for ductal carcinoma in situ (DCIS) is controversial. Using population-cohort data, we examined whether SLNB improves long-term outcomes among patients with DCIS who underwent breast-conserving surgery. We identified 12 776 women aged 67–94 years diagnosed during 2001–2013 with DCIS who underwent breast-conserving surgery from the US Surveillance, Epidemiology, and End Results-Medicare dataset, 1992 (15.6%) of whom underwent SLNB (median follow-up: 69 months). Tests of statistical significance are two-sided. Patients with and without SLNB did not differ statistically significantly regarding treated recurrence (3.9% vs 3.7%; P = .62), ipsilateral invasive occurrence (1.4% vs 1.7%, P = .33), or breast cancer mortality (1.0% vs 0.9%, P = .86). With Mahalanobis-matching and competing-risks survival analyses, SLNB was not statistically significantly associated with treated recurrence, ipsilateral invasive occurrence, or breast cancer mortality (P ≥ .27). Our findings do not support the routine performance of SLNB for older patients with DCIS amenable to breast conservation.

scholarly journals RE: Long-Term Outcomes of Sentinel Lymph Node Biopsy for Ductal Carcinoma in Situ

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Claudia J C Meurs ◽  
Marian B E Menke-Pluijmers ◽  
Sabine Siesling ◽  
Pieter J Westenend
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lymph Node Biopsy ◽  
Long Term Outcomes ◽  
Node Biopsy

Indication of sentinel lymph node biopsy with breast-conserving surgery for ductal carcinoma in situ considering lymphatic flow.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 192-192
Author(s):  
Ayane Yamaguchi ◽  
Shigeru Tsuyuki ◽  
Miru Okamura ◽  
Yukiko Kawata ◽  
Kosuke Kawaguchi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Outer Quadrant ◽  
Lymphatic Flow ◽  
Node Biopsy

192 Background: Ductal carcinoma in situ (DCIS) has been regarded as curable with resection, but axillary lymph node metastases have been reported in 2% of DCIS patients. Even when DCIS has been diagnosed by preoperative core needle biopsy (CNB), 8% to 38% of the patients have been found to have invasive ductal carcinoma (IDC) on the basis of pathological diagnosis after surgical treatment. The indication of sentinel lymph node biopsy (SLNB) and breast-conserving surgery (BCS) for DCIS is still controversial. Methods: SLNB is a standard surgical technique for early breast cancer treatment, and indocyanine green (ICG) fluorescence method is remarkable in terms of the visualization of lymphatic flow. We analyzed the variation in lymphatic drainage routes from the nipple to the SLN (sentinel lymphatic routes) by using the ICG florescence method in early breast cancer patients and investigated the effects on the localization of the tumor to the sentinel lymphatic routes after BCS. Results: From November 2010 to April 2012, we recorded the sentinel lymphatic routes in 118 patients. All the routes passed through the upper outer quadrant (UOQ) area, and there were more than 2 routes in 53 cases. Of these routes, 73% passed through only the UOQ area and 27% passed through the UOQ via the upper inner, lower inner, and/or lower outer quadrant area. Conclusions: We should confirm the sentinel lymphatic routes by using the ICG florescence method before BCS for preoperatively diagnosed DCIS. If the lymphatic routes do not pass over the extent of resection of BCS, we can omit SLNB in the first surgical treatment and await the final pathological result. However, we should perform SLNB in addition to BCS in cases in which the lymphatic routes pass over the tumor in the region except the UOQ area.

Indication for sentinel lymph node biopsy for breast cancer when core biopsy shows ductal carcinoma in situ

2011 ◽  
Vol 202 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Tomohiro Miyake ◽  
Kenzo Shimazu ◽  
Hiroshi Ohashi ◽  
Tetsuya Taguchi ◽  
Satsuki Ueda ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lymph Node Biopsy ◽  
Node Biopsy

scholarly journals Patient Prognostic Score and Associations With Survival Improvement Offered by Radiotherapy After Breast-Conserving Surgery for Ductal Carcinoma In Situ: A Population-Based Longitudinal Cohort Study

2016 ◽  
Vol 34 (11) ◽  
pp. 1190-1196 ◽  
Author(s):  
Yasuaki Sagara ◽  
Rachel A. Freedman ◽  
Ines Vaz-Luis ◽  
Melissa Anne Mallory ◽  
Stephanie M. Wong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Local Recurrence ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Prognostic Score ◽  
Breast Cancer Mortality ◽  
Breast Conserving Surgery ◽  
Population Based

Purpose Radiotherapy (RT) after breast-conserving surgery (BCS) is a standard treatment option for the management of ductal carcinoma in situ (DCIS). We sought to determine the survival benefit of RT after BCS on the basis of risk factors for local recurrence. Patients and Methods A retrospective longitudinal cohort study was performed to identify patients with DCIS diagnosed between 1988 and 2007 and treated with BCS by using SEER data. Patients were divided into the following two groups: BCS+RT (RT group) and BCS alone (non-RT group). We used a patient prognostic scoring model to stratify patients on the basis of risk of local recurrence. We performed a Cox proportional hazards model with propensity score weighting to evaluate breast cancer mortality between the two groups. Results We identified 32,144 eligible patients with DCIS, 20,329 (63%) in the RT group and 11,815 (37%) in the non-RT group. Overall, 304 breast cancer–specific deaths occurred over a median follow-up of 96 months, with a cumulative incidence of breast cancer mortality at 10 years in the weighted cohorts of 1.8% (RT group) and 2.1% (non-RT group; hazard ratio, 0.73; 95% CI, 0.62 to 0.88). Significant improvements in survival in the RT group compared with the non-RT group were only observed in patients with higher nuclear grade, younger age, and larger tumor size. The magnitude of the survival difference with RT was significantly correlated with prognostic score (P < .001). Conclusion In this population-based study, the patient prognostic score for DCIS is associated with the magnitude of improvement in survival offered by RT after BCS, suggesting that decisions for RT could be tailored on the basis of patient factors, tumor biology, and the prognostic score.

Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update

2017 ◽  
Vol 35 (5) ◽  
pp. 561-564 ◽  
Author(s):  
Gary H. Lyman ◽  
Mark R. Somerfield ◽  
Linda D. Bosserman ◽  
Cheryl L. Perkins ◽  
Donald L. Weaver ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Node Biopsy

Purpose To provide current recommendations on the use of sentinel node biopsy (SNB) for patients with early-stage breast cancer. Methods PubMed and the Cochrane Library were searched for randomized controlled trials, systematic reviews, meta-analyses, and clinical practice guidelines from 2012 through July 2016. An Update Panel reviewed the identified abstracts. Results Of the eight publications identified and reviewed, none prompted a change in the 2014 recommendations, which are reaffirmed by the updated literature review. Conclusion Women without sentinel lymph node (SLN) metastases should not receive axillary lymph node dissection (ALND). Women with one to two metastatic SLNs who are planning to undergo breast-conserving surgery with whole-breast radiotherapy should not undergo ALND (in most cases). Women with SLN metastases who will undergo mastectomy should be offered ALND. These three recommendations are based on randomized controlled trials. Women with operable breast cancer and multicentric tumors, with ductal carcinoma in situ, who will undergo mastectomy, who previously underwent breast and/or axillary surgery, or who received preoperative/neoadjuvant systemic therapy may be offered SNB. Women who have large or locally advanced invasive breast cancer (tumor size T3/T4), inflammatory breast cancer, or ductal carcinoma in situ (when breast-conserving surgery is planned) or are pregnant should not undergo SNB.

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