Abstract:
BACKGROUND:Microinvasive ductal carcinoma (DCISM), defined as DCIS with a focus of invasive carcinoma ≤ 1 mm, can be managed similarly to pure DCIS; however, management of the axilla in DCISM has been a subject of debate. Reports in the literature differ on the utility and necessity of sentinel lymph node biopsy (SLNB) for DCISM. The aim of the present study was to identify risk factors for nodal disease in patients with DCISM, which can help develop a selective approach to SLNB in this patient population. METHODS:The National Cancer Database was used to select patients with DCISM (pT1mi), diagnosed from 2012 to 2015, who underwent SLNB. Multivariable regression analysis was performed to determine associations between sentinel lymph node metastasis and relevant clinical variables. RESULTS:Our cohort comprised of 2609 patients with pT1mi who underwent SLNB. Of these, 76 (2.9%) were found to have sentinel lymph node metastases on final pathology. Low/intermediate grade tumors were associated with decreased SLN metastasis (OR 0.50, CI 0.28-0.92). Age and receptor status of the tumor did not have a clear association in predicting SLN metastases. CONCLUSIONS:The rate of sentinel node metastases in DCISM is low at only 2.9% in this national study. Tumor grade was identified as influencing the risk of SLN metastases. This information can factor into shared decision-making for SLNB in patients with DCISM.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Fan B,Pardo JA,Serres S,Alapati AC,Szewczyk J,Mele A,James TAdoi
10.1245/s10434-020-08606-3subject
Has Abstractpub_date
2020-10-01 00:00:00pages
4468-4473issue
11eissn
1068-9265issn
1534-4681pii
10.1245/s10434-020-08606-3journal_volume
27pub_type
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journal_title:Annals of surgical oncology
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pub_type: 杂志文章,已发布勘误
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