Sentinel lymph node metastasis from mammary ductal carcinoma in situ with microinvasion

Zavagno, G.; Belardinelli, V.; Marconato, R.; Carcoforo, Paolo; Franchini, Zeno; Scalco, G.; Burelli, Paolo; Pietrarota, Paolo; Mencarelli, Roberto; Marconato, Giorgia; Nitti, Donato

doi:10.1016/j.breast.2006.08.002

Cited by 44 publications

(25 citation statements)

References 21 publications

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“…However, this imaging feature is less commonly encountered in cases with pure DCIS, where calcifications in the absence of a mass are a more common finding (Dershaw et al, 1989;Ikeda et al, 1989). The mammographic microcalcification rate in patients with DCISM ranges between 61% and 83% (Sakr et al, 2006;Zavagno et al, 2007). In our study, the majority of patients with DCISM (68%) had microcalcifications, whereas only 16% of them had a mammographic mass.…”

Section: Discussionmentioning

confidence: 46%

“…In contrast, they also noted that the rate of RT after lumpectomy increased from 38% to 54% over the study period. Furthermore, up to half of the DCIS patients reportedly underwent ALND, a potentially morbid procedure with questionable long-term benefits and a limited role in routine treatment of this disease (Lagios et al, 1989;Sakr et al, 2006;Zavagno et al, 2007). Similarly, according to a study by Baxter et al (2004), the rate of mastectomy decreased from 43% in 1992 to 28% in 1999, and the rate of ALND decreased from 34 to 15% during the same time period (Baxter et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…The significance of DCISM is still debated and clinical management of this condition remains controversial (Silver et al, 1998;Zavagno et al, 2007). DCISM accounts for less than 1% of all breast cancers, and 13.5% of all DCIS cases have a microinvasive component (Siverstein et al, 1990).…”

Section: Discussionmentioning

confidence: 99%

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Factors Predicting Microinvasion in Ductal Carcinoma in situ

Ozkan-Gurdal¹,

Cabıoğlu²,

Özçınar³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Whether sentinel lymph node biopsy (SLNB) should be performed in patients with pure ductal carcinoma in situ (DCIS) of the breast has been a question of debate over the last decade. The aim of this study was to identify factors associated with microinvasive disease and determine the criteria for performing SLNB in patients with DCIS. Materials and Methods: 125 patients with DCIS who underwent surgery between January 2000 and December 2008 were reviewed to identify factors associated with DCIS and DCIS with microinvasion (DCISM). Results: 88 patients (70.4%) had pure DCIS and 37 (29.6%) had DCISM. Among 33 DCIS patients who underwent SLNB, one patient (3.3%) was found to have isolated tumor cells in her biopsy, whereas 1 of 14 (37.8%) patients with DCISM had micrometastasis (7.1%). Similarly, of 16 patients (18.2%) with pure DCIS and axillary lymph node dissection (ALND) without SLNB, none had lymph node metastasis. Furthermore, of 20 patients with DCISM and ALND, only one (5%) had metastasis. In multivariate analysis, the presence of comedo necrosis [relative risk (RR)=4.1, 95% confidence interval (CI)=1.6-10.6, P=0.004], and hormone receptor (ER or PR) negativity (RR=4.0, 95%CI=1.5-11, P=0.007), were found to be significantly associated with microinvasion. Conclusions: Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with comedo necrosis or hormone receptor negativity are more likely to have a microinvasive component in definitive pathology following surgery, and should be considered for SLNB procedure along with patients who will undergo mastectomy due to DCIS.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

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Factors Predicting Microinvasion in Ductal Carcinoma in situ

Ozkan-Gurdal¹,

Cabıoğlu²,

Özçınar³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Simpson et al [32] 1992 Foci of stromal invasion, maximum size not specified 5 1 (20) Solin et al [16] 1992 Invasion less than or equal 2 mm or comprising less than 10% of the tumour [45] 2003 1 focus or more foci, each less or equal to 1 mm 41 a 4 (9.7) Yang et al [46] 2003 1 focus or more foci, each less or equal to 1 mm 26 0 Buttarelli et al [47] 2004 1 focus or more foci, each less or equal to 1 mm 11 a 1 (9.1) Giard et al [48] 2005 1 focus or more foci, each less or equal to 1 mm 32 a 1 (1.1) Wilkie et al [49] 2005 1 focus or more foci, each less than 1 mm 51 a 7 (13.7) Katz et al [50] 2006 1 focus or more foci, each less or equal to 1 mm 21 a 2 (9.5) Leidenius et al [51] 2006 1 focus or more foci, each less or equal to 1 mm 11 a 1 (9.0) Gray et al [52] 2007 1 focus or more foci, each less or equal to 1 mm 81 a 6 (7.4) Le Bouedec et al [53] 2007 1 focus or more foci, each less or equal to 1 mm 40 a 4 (10%) Zavagno et al [54] 2007 1 focus or more foci, each less or equal to 1 mm 43 a 4 (9.3) a Series with sentinel lymph node biopsy 20% (9-11, 15-18, 31-54; Table 1). This wide range may be explained by both the different histopathological criteria used to define what constitutes microinvasion and the variable degrees of breast tissue sampling, but also it depends on the different techniques utilized to stain axillary lymph nodes (hematoxylin and eosin or IHC) especially after the introduction of sentinel lymph node (SLN) biopsy.…”

Section: Clinical Significance Of Microinvasionmentioning

confidence: 99%

Microinvasive Carcinoma of the Breast

Bianchi

Vezzosi

2008

Pathol. Oncol. Res.

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The increased rate of early detection of breast cancer due to widespread mammographic screening has led to an increased incidence not only of in situ but also microinvasive carcinoma (MC). MC has been reported to have a favourable prognosis, but specific definitions have varied in the past making the clinical significance of this entity a subject of debate. In fact, although the diagnosis of MC often appears in pathology reports, this term has not been used in a consistent, standardized manner. In addition, the histological diagnosis of MC can be problematical for the pathologist due to a variety of in situ patterns and artefacts that may be misinterpreted as stromal invasion. Definitions and diagnostic criteria of MC are reviewed and discussed. Based on a review of literature, incidence of axillary lymph node involvement, according to different definitions of microinvasion, is reported.

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“…A introdução da biópsia de linfonodo sentinela (BLS) permitiu um novo pensamento acerca da investigação do status axilar nos casos de microinvasão, pois este procedimento tem menor morbidade e permite um estadiamento mais preciso usando cortes seriados e estudo imuno-histoquímico do linfonodo sentinela. A taxa de BLS positivo em pacientes com diagnóstico de microinvasão tem se mostrado baixa na totalidade de estudos acerca do assunto [15][16][17][18][19][20][21] . A sobrevida do CMM é igual à sobrevida das pacientes diagnosticadas com CDIS puro.…”

Section: Discussionunclassified

Carcinoma microinvasor de mama: resultados em longo prazo

Gioia¹,

Marinho²,

Murteira³

et al. 2016

Rev. Bras. Mastol. (Impr.)

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A aparência radiológica das calcificações encontrada nas lesões de CMM (68%) mimetizou os achados vistos no CDIS. Axila positiva foi encontrada em 9,6% dos casos. Após um seguimento médio de oito anos, foi observado um caso de recidiva loco regional e quatro casos de recidiva à distancia. A sobrevida global foi de 95,6% e a sobrevida livre de doença, de 96,5%. Conclusão: Apesar do potencial de metástase nodal no nosso estudo, o CMM possui um bom prognóstico e é associado ao baixo risco de metástase para linfonodos axilares. O conhecimento da clínica e da radiologia de lesões com CDIS poderá alertar ao médico sobre a possibilidade de microinvasão e orientação do manejo adequado para cada paciente. ABSTRACT Objective: Microinvasive breast carcinoma (MBC) is an uncommon breast carcinoma subtype although an increase of screening mammography in recent decades has resulted in a higher incidence of ductal carcinoma in situ (DCIS), as well as invasive carcinomas at early stages. The objective of this research study was to review 115 cases of MBC from Brazilian National Cancer

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Sentinel lymph node metastasis from mammary ductal carcinoma in situ with microinvasion

Cited by 44 publications

References 21 publications

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Microinvasive Carcinoma of the Breast

Carcinoma microinvasor de mama: resultados em longo prazo

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