Reversing the Dilemma of Sentinel Lymph Node Biopsy in Ductal Carcinoma In Situ (DCIS)

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Instead of trying to identify patients with underlying invasion:
    • Let’s find a way to mark the sentinel lymph node (SLN) in advance
  • Senti nel Lymph Node Dissection in DCIS and how to
  • Not to do it
  • The SentiNot Trial
    • Concept:
      • Inject supraparamagnetic iron oxide particles (SPIO) at the primary operation:
        • Mark the SLN but do not remove it
      • If pathology report shows invasion:
        • Then we can go back and perform the SLNB
    • A multicenter cohort study:
      • Has been completed
    • Multicenter randomized trial:
      • Is ongoing
Inclusion criteria: Grade 2, > 20 mm, any grade 3, mass forming DCIS, Andy DCIS planned for mastectomy
The detection rate in the WLE were not different but in the setting of OPBCT and mastectomy the detection rate was inferior to standard technique
The procedure was not accurate in any setting others than WLE
  • Conclusion of SentiNot:
    • 77.2% of patients avoided upfront DCIS
    • Higher detection rate, nodal yield and accuracy
    • Incremental cost containment
#Arrangoiz #Doctor #Surgeon #CancerSurgeon #SurgicalOncologist #BreastCancer #DCIS #MountSinaiMedicalCenter #MSMC #Miami #Mexico
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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