- DCIS is noninvasive:
- By definition, is unable to metastasize:
- However, studies have shown that up to 15% of patients with pure DCIS:
- Have isolated tumor cells (ITCs) or micrometastasis on nodal evaluation
- However, these small tumor deposits:
- Likely have little prognostic significance:
- They may represent only cell clusters displaced by biopsy
- Likely have little prognostic significance:
- However, studies have shown that up to 15% of patients with pure DCIS:
- By definition, is unable to metastasize:
- In patients with DCIS detected by core biopsy:
- There is a 15% to 20% associated risk:
- Of an invasive component when excised
- There is a 15% to 20% associated risk:
- Patients undergoing mastectomy for DCIS:
- Should be offered SLNB:
- Since it would not be feasible to perform following mastectomy:
- If invasive carcinoma is subsequently identified
- Since it would not be feasible to perform following mastectomy:
- Should be offered SLNB:
- ASCO consensus guidelines recommend that:
- Patients with DCIS who undergo breast-conserving operation should not routinely have SLNB:
- However, SLNB could be discussed with patients undergoing breast conservation:
- Who have a core biopsy diagnosis of DCIS and:
- A large area of DCIS on imaging (2 cm to 5 cm)
- High-grade DCIS
- Comedonecrosis
- When a physical examination or imaging:
- Shows a discrete mass
- Who have a core biopsy diagnosis of DCIS and:
- These findings have been associated with an increased risk of invasive cancer:
- And SLNB at the time of the initial operation could avoid a second operation
- However, SLNB could be discussed with patients undergoing breast conservation:
- Patients with DCIS who undergo breast-conserving operation should not routinely have SLNB:
#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #Surgeon #Teacher #BreastCancer #BreastDiseases #AxillaryDissection #BreastSurgery #MountSinaiMedicalCenter #MSMC #Miami #Mexico #SLNM #SLNB #SentinelLymphNodeBiopsy
Rodrigo Arrangoiz MS, MD, FACS, FSSO 