Role of axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast
Identifieur interne : 001B06 ( Pmc/Curation ); précédent : 001B05; suivant : 001B07Role of axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast
Auteurs : Giorgio Zavagno [Italie] ; Paolo Carcoforo [Italie] ; Renato Marconato [Italie] ; Zeno Franchini [Italie] ; Giuliano Scalco [Italie] ; Paolo Burelli [Italie] ; Paolo Pietrarota [Italie] ; Mario Lise [Italie] ; Roberto Mencarelli [Italie] ; Giovanni Capitanio [Italie] ; Andrea Ballarin [Italie] ; Maria Elena Pierobon [Italie] ; Giorgia Marconato [Italie] ; Donato Nitti [Italie]Source :
- BMC Cancer [ 1471-2407 ] ; 2005.
Abstract
Sentinel lymph node (SLN) biopsy is an effective tool for axillary staging in patients with invasive breast cancer. This procedure has been recently proposed as part of the treatment for patients with ductal carcinoma in situ (DCIS), because cases of undetected invasive foci and nodal metastases occasionally occur. However, the indications for SLN biopsy in DCIS patients are controversial.
The aim of the present study was therefore to assess the incidence of SLN metastases in a series of patients with a diagnosis of pure DCIS.
A retrospective evaluation was made of a series of 102 patients who underwent SLN biopsy, and had a final histologic diagnosis of pure DCIS. Patients with microinvasion were excluded from the analysis. The patients were operated on in five Institutions between 1999 and 2004.
Subdermal or subareolar injection of 30–50 MBq of 99 m-Tc colloidal albumin was used for SLN identification. All sentinel nodes were evaluated with serial sectioning, haematoxylin and eosin staining, and immunohistochemical analysis for cytocheratin.
Only one patient (0.98%) was SLN positive. The primary tumour was a small micropapillary intermediate-grade DCIS and the SLN harboured a micrometastasis. At pathologic revision of the specimen, no detectable focus of microinvasion was found.
Our findings indicate that SLN metastases in pure DCIS are a very rare occurrence. SLN biopsy should not therefore be routinely performed in patients who undergo resection for DCIS. SLN mapping can be performed, as a second operation, in cases in which an invasive component is identified in the specimen. Only DCIS patients who require a mastectomy should have SLN biopsy performed at the time of breast operation, since in these cases subsequent node mapping is not feasible.
Url:
DOI: 10.1186/1471-2407-5-28
PubMed: 15762990
PubMed Central: 555738
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of Padova, Via Gabelli 61, 35128 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Anatomia Patologica, University of Padova, Via Gabelli 61, 35128 Padova</wicri:regionArea></affiliation></author><author><name sortKey="Capitanio, Giovanni" sort="Capitanio, Giovanni" uniqKey="Capitanio G" first="Giovanni" last="Capitanio">Giovanni Capitanio</name><affiliation wicri:level="1"><nlm:aff id="I9">Anatomia Patologica, Hospital of Venezia, Castello 6776, 30122 Venezia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Anatomia Patologica, Hospital of Venezia, Castello 6776, 30122 Venezia</wicri:regionArea></affiliation></author><author><name sortKey="Ballarin, Andrea" sort="Ballarin, Andrea" uniqKey="Ballarin A" first="Andrea" last="Ballarin">Andrea Ballarin</name><affiliation wicri:level="1"><nlm:aff id="I4">Chirurgia Generale I, Hospital "Borgo Trento", Piazzale Stefani 1, 37126 Verona, Italy</nlm:aff><country 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Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova</wicri:regionArea></affiliation></author><author><name sortKey="Nitti, Donato" sort="Nitti, Donato" uniqKey="Nitti D" first="Donato" last="Nitti">Donato Nitti</name><affiliation wicri:level="1"><nlm:aff id="I1">Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">15762990</idno><idno type="pmc">555738</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC555738</idno><idno type="RBID">PMC:555738</idno><idno type="doi">10.1186/1471-2407-5-28</idno><date when="2005">2005</date><idno type="wicri:Area/Pmc/Corpus">001B07</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001B07</idno><idno type="wicri:Area/Pmc/Curation">001B06</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001B06</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Role of axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast</title><author><name sortKey="Zavagno, Giorgio" sort="Zavagno, Giorgio" uniqKey="Zavagno G" first="Giorgio" last="Zavagno">Giorgio Zavagno</name><affiliation wicri:level="1"><nlm:aff id="I1">Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova</wicri:regionArea></affiliation></author><author><name sortKey="Carcoforo, Paolo" sort="Carcoforo, Paolo" uniqKey="Carcoforo P" first="Paolo" last="Carcoforo">Paolo Carcoforo</name><affiliation wicri:level="1"><nlm:aff id="I2">Chirurgia Generale, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Chirurgia Generale, University of Ferrara, Corso Giovecca 203, 44100 Ferrara</wicri:regionArea></affiliation></author><author><name sortKey="Marconato, Renato" sort="Marconato, Renato" uniqKey="Marconato R" first="Renato" last="Marconato">Renato Marconato</name><affiliation wicri:level="1"><nlm:aff id="I3">Chirurgia Generale, Hospital of Venezia, Castello 6776, 30122 Venezia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Chirurgia Generale, Hospital of Venezia, Castello 6776, 30122 Venezia</wicri:regionArea></affiliation></author><author><name sortKey="Franchini, Zeno" sort="Franchini, Zeno" uniqKey="Franchini Z" first="Zeno" last="Franchini">Zeno Franchini</name><affiliation wicri:level="1"><nlm:aff id="I4">Chirurgia Generale I, Hospital "Borgo Trento", Piazzale Stefani 1, 37126 Verona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Chirurgia Generale I, Hospital "Borgo Trento", Piazzale Stefani 1, 37126 Verona</wicri:regionArea></affiliation></author><author><name sortKey="Scalco, Giuliano" sort="Scalco, Giuliano" uniqKey="Scalco G" first="Giuliano" last="Scalco">Giuliano Scalco</name><affiliation wicri:level="1"><nlm:aff id="I5">Chirurgia Generale II, Hospital of Vicenza, Via Rodolfi 6, 36100 Vicenza, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Chirurgia Generale II, Hospital of Vicenza, Via Rodolfi 6, 36100 Vicenza</wicri:regionArea></affiliation></author><author><name sortKey="Burelli, Paolo" sort="Burelli, Paolo" uniqKey="Burelli P" first="Paolo" last="Burelli">Paolo Burelli</name><affiliation wicri:level="1"><nlm:aff id="I6">Chirurgia Generale, Hospital of Conegliano, Via Bisagno 4, 31015 Conegliano, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Chirurgia Generale, Hospital of Conegliano, Via Bisagno 4, 31015 Conegliano</wicri:regionArea></affiliation></author><author><name sortKey="Pietrarota, Paolo" sort="Pietrarota, Paolo" uniqKey="Pietrarota P" first="Paolo" last="Pietrarota">Paolo Pietrarota</name><affiliation wicri:level="1"><nlm:aff id="I7">Chirurgia Generale II, Hospital "Borgo Trento", Piazzale Stefani 1, 37126 Verona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Chirurgia Generale II, Hospital "Borgo Trento", Piazzale Stefani 1, 37126 Verona</wicri:regionArea></affiliation></author><author><name sortKey="Lise, Mario" sort="Lise, Mario" uniqKey="Lise M" first="Mario" last="Lise">Mario Lise</name><affiliation wicri:level="1"><nlm:aff id="I1">Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova</wicri:regionArea></affiliation></author><author><name sortKey="Mencarelli, Roberto" sort="Mencarelli, Roberto" uniqKey="Mencarelli R" first="Roberto" last="Mencarelli">Roberto Mencarelli</name><affiliation wicri:level="1"><nlm:aff id="I8">Anatomia Patologica, University of Padova, Via Gabelli 61, 35128 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Anatomia Patologica, University of Padova, Via Gabelli 61, 35128 Padova</wicri:regionArea></affiliation></author><author><name sortKey="Capitanio, Giovanni" sort="Capitanio, Giovanni" uniqKey="Capitanio G" first="Giovanni" last="Capitanio">Giovanni Capitanio</name><affiliation wicri:level="1"><nlm:aff id="I9">Anatomia Patologica, Hospital of Venezia, Castello 6776, 30122 Venezia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Anatomia Patologica, Hospital of Venezia, Castello 6776, 30122 Venezia</wicri:regionArea></affiliation></author><author><name sortKey="Ballarin, Andrea" sort="Ballarin, Andrea" uniqKey="Ballarin A" first="Andrea" last="Ballarin">Andrea Ballarin</name><affiliation wicri:level="1"><nlm:aff id="I4">Chirurgia Generale I, Hospital "Borgo Trento", Piazzale Stefani 1, 37126 Verona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Chirurgia Generale I, Hospital "Borgo Trento", Piazzale Stefani 1, 37126 Verona</wicri:regionArea></affiliation></author><author><name sortKey="Pierobon, Maria Elena" sort="Pierobon, Maria Elena" uniqKey="Pierobon M" first="Maria Elena" last="Pierobon">Maria Elena Pierobon</name><affiliation wicri:level="1"><nlm:aff id="I1">Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova</wicri:regionArea></affiliation></author><author><name sortKey="Marconato, Giorgia" sort="Marconato, Giorgia" uniqKey="Marconato G" first="Giorgia" last="Marconato">Giorgia Marconato</name><affiliation wicri:level="1"><nlm:aff id="I1">Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova</wicri:regionArea></affiliation></author><author><name sortKey="Nitti, Donato" sort="Nitti, Donato" uniqKey="Nitti D" first="Donato" last="Nitti">Donato Nitti</name><affiliation wicri:level="1"><nlm:aff id="I1">Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Cancer</title><idno type="eISSN">1471-2407</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Sentinel lymph node (SLN) biopsy is an effective tool for axillary staging in patients with invasive breast cancer. This procedure has been recently proposed as part of the treatment for patients with ductal carcinoma in situ (DCIS), because cases of undetected invasive foci and nodal metastases occasionally occur. However, the indications for SLN biopsy in DCIS patients are controversial.</p><p>The aim of the present study was therefore to assess the incidence of SLN metastases in a series of patients with a diagnosis of pure DCIS.</p></sec><sec sec-type="methods"><title>Methods</title><p>A retrospective evaluation was made of a series of 102 patients who underwent SLN biopsy, and had a final histologic diagnosis of pure DCIS. Patients with microinvasion were excluded from the analysis. The patients were operated on in five Institutions between 1999 and 2004.</p><p>Subdermal or subareolar injection of 30–50 MBq of 99 m-Tc colloidal albumin was used for SLN identification. All sentinel nodes were evaluated with serial sectioning, haematoxylin and eosin staining, and immunohistochemical analysis for cytocheratin.</p></sec><sec><title>Results</title><p>Only one patient (0.98%) was SLN positive. The primary tumour was a small micropapillary intermediate-grade DCIS and the SLN harboured a micrometastasis. At pathologic revision of the specimen, no detectable focus of microinvasion was found.</p></sec><sec><title>Conclusion</title><p>Our findings indicate that SLN metastases in pure DCIS are a very rare occurrence. SLN biopsy should not therefore be routinely performed in patients who undergo resection for DCIS. SLN mapping can be performed, as a second operation, in cases in which an invasive component is identified in the specimen. Only DCIS patients who require a mastectomy should have SLN biopsy performed at the time of breast operation, since in these cases subsequent node mapping is not feasible.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Cancer</journal-id><journal-title>BMC Cancer</journal-title><issn pub-type="epub">1471-2407</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">15762990</article-id><article-id pub-id-type="pmc">555738</article-id><article-id pub-id-type="publisher-id">1471-2407-5-28</article-id><article-id pub-id-type="doi">10.1186/1471-2407-5-28</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Role of axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast</article-title></title-group><contrib-group><contrib id="A1" corresp="yes" contrib-type="author"><name><surname>Zavagno</surname><given-names>Giorgio</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>giorgio.zavagno@unipd.it</email></contrib><contrib id="A2" contrib-type="author"><name><surname>Carcoforo</surname><given-names>Paolo</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>ccf@unife.it</email></contrib><contrib id="A3" contrib-type="author"><name><surname>Marconato</surname><given-names>Renato</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>renanet@aliceposta.it</email></contrib><contrib id="A4" contrib-type="author"><name><surname>Franchini</surname><given-names>Zeno</given-names></name><xref ref-type="aff" rid="I4">4</xref><email>chirurgia.generale.prima@azosp.vr.it</email></contrib><contrib id="A5" contrib-type="author"><name><surname>Scalco</surname><given-names>Giuliano</given-names></name><xref ref-type="aff" rid="I5">5</xref><email>giuscalco@tin.it</email></contrib><contrib id="A6" contrib-type="author"><name><surname>Burelli</surname><given-names>Paolo</given-names></name><xref ref-type="aff" rid="I6">6</xref><email>pburelli@ulss7.it</email></contrib><contrib id="A7" contrib-type="author"><name><surname>Pietrarota</surname><given-names>Paolo</given-names></name><xref ref-type="aff" rid="I7">7</xref><email>pietrarota@libero.it</email></contrib><contrib id="A8" contrib-type="author"><name><surname>Lise</surname><given-names>Mario</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>mario.lise@unipd.it</email></contrib><contrib id="A9" contrib-type="author"><name><surname>Mencarelli</surname><given-names>Roberto</given-names></name><xref ref-type="aff" rid="I8">8</xref><email>roberto.mencarelli@sanita.padova.it</email></contrib><contrib id="A10" contrib-type="author"><name><surname>Capitanio</surname><given-names>Giovanni</given-names></name><xref ref-type="aff" rid="I9">9</xref><email>giorgio.zavagno@unipd.it</email></contrib><contrib id="A11" contrib-type="author"><name><surname>Ballarin</surname><given-names>Andrea</given-names></name><xref ref-type="aff" rid="I4">4</xref><email>chirurgia.generale.prima@azosp.vr.it</email></contrib><contrib id="A12" contrib-type="author"><name><surname>Pierobon</surname><given-names>Maria Elena</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>maryxagosto@yahoo.it</email></contrib><contrib id="A13" contrib-type="author"><name><surname>Marconato</surname><given-names>Giorgia</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>giorgiamarconato@libero.it</email></contrib><contrib id="A14" contrib-type="author"><name><surname>Nitti</surname><given-names>Donato</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>donato.nitti@unipd.it</email></contrib></contrib-group><aff id="I1"><label>1</label>Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova, Italy</aff><aff id="I2"><label>2</label>Chirurgia Generale, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy</aff><aff id="I3"><label>3</label>Chirurgia Generale, Hospital of Venezia, Castello 6776, 30122 Venezia, Italy</aff><aff id="I4"><label>4</label>Chirurgia Generale I, Hospital "Borgo Trento", Piazzale Stefani 1, 37126 Verona, Italy</aff><aff id="I5"><label>5</label>Chirurgia Generale II, Hospital of Vicenza, Via Rodolfi 6, 36100 Vicenza, Italy</aff><aff id="I6"><label>6</label>Chirurgia Generale, Hospital of Conegliano, Via Bisagno 4, 31015 Conegliano, Italy</aff><aff id="I7"><label>7</label>Chirurgia Generale II, Hospital "Borgo Trento", Piazzale Stefani 1, 37126 Verona, Italy</aff><aff id="I8"><label>8</label>Anatomia Patologica, University of Padova, Via Gabelli 61, 35128 Padova, Italy</aff><aff id="I9"><label>9</label>Anatomia Patologica, Hospital of Venezia, Castello 6776, 30122 Venezia, Italy</aff><pub-date pub-type="collection"><year>2005</year></pub-date><pub-date pub-type="epub"><day>11</day><month>3</month><year>2005</year></pub-date><volume>5</volume><fpage>28</fpage><lpage>28</lpage><ext-link ext-link-type="uri" xlink:href="http://www.biomedcentral.com/1471-2407/5/28"></ext-link><history><date date-type="received"><day>13</day><month>11</month><year>2004</year></date><date date-type="accepted"><day>11</day><month>3</month><year>2005</year></date></history><copyright-statement>Copyright © 2005 Zavagno et al; licensee BioMed Central Ltd.</copyright-statement><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0"></ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p></license><abstract><sec><title>Background</title><p>Sentinel lymph node (SLN) biopsy is an effective tool for axillary staging in patients with invasive breast cancer. This procedure has been recently proposed as part of the treatment for patients with ductal carcinoma in situ (DCIS), because cases of undetected invasive foci and nodal metastases occasionally occur. However, the indications for SLN biopsy in DCIS patients are controversial.</p><p>The aim of the present study was therefore to assess the incidence of SLN metastases in a series of patients with a diagnosis of pure DCIS.</p></sec><sec sec-type="methods"><title>Methods</title><p>A retrospective evaluation was made of a series of 102 patients who underwent SLN biopsy, and had a final histologic diagnosis of pure DCIS. Patients with microinvasion were excluded from the analysis. The patients were operated on in five Institutions between 1999 and 2004.</p><p>Subdermal or subareolar injection of 30–50 MBq of 99 m-Tc colloidal albumin was used for SLN identification. All sentinel nodes were evaluated with serial sectioning, haematoxylin and eosin staining, and immunohistochemical analysis for cytocheratin.</p></sec><sec><title>Results</title><p>Only one patient (0.98%) was SLN positive. The primary tumour was a small micropapillary intermediate-grade DCIS and the SLN harboured a micrometastasis. At pathologic revision of the specimen, no detectable focus of microinvasion was found.</p></sec><sec><title>Conclusion</title><p>Our findings indicate that SLN metastases in pure DCIS are a very rare occurrence. SLN biopsy should not therefore be routinely performed in patients who undergo resection for DCIS. SLN mapping can be performed, as a second operation, in cases in which an invasive component is identified in the specimen. Only DCIS patients who require a mastectomy should have SLN biopsy performed at the time of breast operation, since in these cases subsequent node mapping is not feasible.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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