National Comprehensive Cancer Network (NCCN) Guidelines Recommend Consideration of Sentinel Lymph Node Biopsy (SLNB) for Ductal Carcinoma In Situ

  • The likelihood of finding invasive cancer on final pathologic evaluation following a core needle biopsy showing DCIS:
    • Has been reported to vary between 10% to 20%:
      • Therefore, a second operation will be required in this subset of patients who are later found to have invasive cancer
  • NCCN guidelines recommend:
    • Simultaneous performance of a sentinel lymph node biopsy when operating on patients with DCIS on core biopsy if:
      • The index operation may compromise subsequent lymphatic drainage:
        • Such as a mastectomy or a lumpectomy performed on a cancer in the axillary tail of the breast
  • While pathologic subtypes of DCIS may be associated with higher risks of local recurrence:
    • The presence of grade 3 disease and comedonecrosis:
      • Are not associated with higher probabilities of nodal involvement
  • Lastly, a history of prior invasive cancer is not associated with a higher probability of invasive cancer when the core biopsy demonstrated DCIS alone
  • References
  • Jakub JW, Murphy BL, Gonzalez AB, Conners AL, Henrichsen TL, Maimone S 4th, et al. A validated nomogram to predict upstaging of ductal carcinoma in situ to invasive disease. Ann Surg Oncol. 2017;24(10):2915-2924.
  • NCCN guidelines Breast Cancer (version 1.2018). National Comprehensive Cancer Network website. Accessed October 18, 2019.

#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #BreastCancer #DCIS #SLNB #Miami #Mexico #Surgeon #Teacher

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s