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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Bae, Soong June Kook, Yoonwon Jang, Ji Soo Baek, Seung Ho Moon, Sohyun Kim, Jung Hyun Lee, Seung Eun Kim, Min Ji Ahn, Sung Gwe Jeong, Joon |
| Abstract | Background Sentinel lymph node biopsy (SLNB) is recommended for patients with ductal carcinoma in situ (DCIS) undergoing mastectomy, given the concerns regarding upstaging and technical difficulties of post-mastectomy SLNB. However, this may lead to potential overtreatment, considering favorable prognosis and de-escalation trends in DCIS. Data regarding upstaging and axillary lymph node metastasis among these patients remain limited. Methods We retrospectively reviewed patients with DCIS who underwent mastectomy with SLNB or axillary lymph node dissection at Gangnam Severance Hospital between January 2010 and December 2021. To explore the feasibility of omitting SLNB, we assessed the rates of DCIS upgraded to invasive carcinoma and axillary lymph node metastasis. Binary Cox regression analysis was performed to identify clinicopathologic factors associated with upstaging and axillary lymph node metastasis. Results Among 385 patients, 164 (42.6%) experienced an invasive carcinoma upgrade: microinvasion, pT1, and pT2 were confirmed in 53 (13.8%), 97 (25.2%), and 14 (3.6%) patients, respectively. Seventeen (4.4%) patients had axillary lymph node metastasis. Multivariable analysis identified age ≤ 50 years (adjusted odds ratio [OR], 12.73; 95% confidence interval [CI], 1.18–137.51; p = 0.036) and suspicious axillary lymph nodes on radiologic evaluation (adjusted OR, 9.31; 95% CI, 2.06–41.99; p = 0.004) as independent factors associated with axillary lymph node metastasis. Among patients aged > 50 years and/or no suspicious axillary lymph nodes, only 1.7–2.3%) experienced axillary lymph node metastasis. Conclusions Although underestimation of the invasive component was relatively high among patients with DCIS undergoing mastectomy, axillary lymph node metastasis was rare. Our findings suggest that omitting SLNB may be feasible for patients over 50 and/or without suspicious axillary lymph nodes on radiologic evaluation. |
| Related Links | https://breast-cancer-research.biomedcentral.com/counter/pdf/10.1186/s13058-024-01816-7.pdf |
| Ending Page | 11 |
| Page Count | 11 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| DOI | 10.1186/s13058-024-01816-7 |
| Journal | Breast Cancer Research |
| Issue Number | 1 |
| Volume Number | 26 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2024-04-12 |
| Access Restriction | Open |
| Subject Keyword | Cancer Research Oncology Surgical Oncology |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cancer Research Oncology |
| Journal Impact Factor | 6.1/2023 |
| 5-Year Journal Impact Factor | 7.1/2023 |
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