Possible causes for the results might be divergent motivations for data collection or restrictions in data collection. It remains unclear which method properly reflects the true status. Selected indicators (e. g. obstetric trauma), however, are suitable to be substituted by hospital administrative data.
! Aim:The study examines the treatment situation associated with operative axillary diagnosis in cases with preoperative histological confirmation of DCIS. It investigates the lymph node metastasis rate in cases of histologically confirmed pure DCIS under current diagnostic and operative conditions. Materials and methods: The study uses data collected by the Federal Quality Assurance Agency in 2008. Results: DCIS confirmed by preoperative needle biopsy proved to be an invasive carcinoma in 20.40 to 25.57 % of all cases at the definitive histological workup and thus required SLNB. SLNB (or ALND) yielded positive findings in at least 17.51 % of these cases. Non-indicated ALND was performed in 4.27 to 2.21 % of the DCIS cases. An axillary intervention (SLNB or ALND) was dispensed with in only 64.40 % of the biopsy-confirmed DCIS cases that were found to be noninvasive, which does not correspond to the current German guidelines. As expected, a trend towards underestimation of large or high-grade DCIS cases was seen here. The 2008 quality assurance data for breast cancer are marred by a certain number of input errors and software defects. Thus the data pool was not assessable in its entirety. Moreover, 33.10 % of the cases were not confirmed preoperatively and thus had to be excluded. Conclusions: Since too many axillary interventions are apparently being performed, it is necessary to discuss whether the regularly updated German guidelines should define the indication for SLNB more precisely in cases with a preoperative histological diagnosis of DCIS.
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