Indications for sentinel lymph node biopsy in patients with ductal carcinoma in situ

Year 2013, Volume: 2 Issue: 2, 47 - 56, 08.09.2013

Emel Canbay , Ali Cercel Fatih Aydoğan Ertuğrul Gazioğlu Mehmet Ferahman Ahmet Kocael Övgü Aydın Zerrin Calay Varol Çelik

https://doi.org/10.12808/bcs.v2i2.25

Abstract

Abstract

Background. Sentinel lymph node biopsy (SLNB) for ductal carcinoma in situ (DCIS) is still controversial. Methods. Between 2002 and 2008, retrospective analysis was performed in patients (n=53) with an initial diagnosis of DCIS who underwent to SLNB and primary surgical procedure. Results. Median age was 52.4 (range, 30-70). Of the 53 patients, 19 (35.8%) cases were upstaged into invasive cancer and 34 (64.2%) cases were diagnosed as pure DCIS in the final diagnosis. Two of 34 (5.8%) patients with pure DCIS and 2 of 19 (10.5%) patients with invasive component had a positive sentinel lymph node. Multivariate logistic regression analysis identified presence of mass (OR: 4.762; 95% CI: 1.571-14.434; p=0.000),  larger tumor size (OR:5.33; 95%CI: 1.309-21.72;  p=0.013) were predictive factors of invasive focus in tumor. Discussion. The rates of SLNB positivity in pure DCIS (5.8%) are high in our series. SLNB might be considered to perform as part of primary surgical procedure when the DCIS patients are under suspicious of upstaging to invasive carcinoma because of palpable mass and tumor larger than 3 cm.

Keywords: Ductal carcinoma in situ, sentinel lymph node biopsy

Özet

Amaç. Sentinel lenf nodu biyopsisi (SLNB) ductal karsinoma in situ (DKIS) için hala tartışmalıdır. Yöntem. Başlangıç tanısı DKİS olan ve 2002-2008 yıllarında SLNB ve primer cerrahi işlem uygulanan hastalar (n=53) retrospektif olarak değerlendirildi. Bulgular. Ortanca yaş 52.4 (aralık 30-70) bulundu. Elli üç olgunun, 19'unda (%35.8) invaziv kansere evre yükseltmesi yapıldı ve 34'ü (%64.2) saf DKİS olarak tanımlandı. Bu 34 olgunun 2'si (%5.8) ve diğer 19 olgunun ikisi (%10.5) sentinel lenf nodu pozitif idi. Multivariate lojistik regresyon analizi kitle bulunması (OR: 4.762; 95% CI: 1.571-14.434; p=0.000) ve büyük tümör çapı (OR: 5.33; 95% CI: 1.309-21.72; p=0.013) bulgularını tümörde invaziv fokus açısından prediktif faktör olarak gösterdi. Sonuçlar. Saf DKİS olgularında SLNB pozitivitesi (%5.8) serimizde yüksek bulundu. SLNB palpabl kitle ve >3 cm tümör çapı nedeniyle invaziv kansere evre yükseltilme olasılığı olan DKİS olgularında primer cerrahi işlemin bir parçası olarak değerlendirilmelidir.

Anahtar sözcükler: Duktal karsinoma in situ, sentinel lenf nodu biyopsisi

Keywords

Ductal carcinoma in situ, sentinel lymph node biopsy

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