Axillary Staging in Ductal Carcinoma In Situ (DCIS)

Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉DCIS is noninvasive and, 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 and may be cell clusters displaced by biopsy.

👉In patients with DCIS detected by core biopsy, there is a 15% to 20% associated risk of an invasive component when excised.

👉Patients undergoing mastectomy for DCIS should be offered sentinel lymph node biopsy (SLNB) since it would not be feasible to perform following a mastectomy if invasive carcinoma is subsequently identified.

👉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 to 5 cm), high-grade DCIS, or comedonecrosis or when a physical examination or imaging shows a discrete mass.

👉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.

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Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

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#Surgeon

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#BreastSurgeon

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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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