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Risk of invasion and axillary lymph node metastasis in ductal carcinoma in situ diagnosed by core-needle biopsy.
Br J Surg. 2007 Aug; 94(8):952-6.BJ

Abstract

BACKGROUND

The aim of the study was to assess the risk of invasion and axillary lymph node metastasis in patients with ductal carcinoma in situ (DCIS) diagnosed by preoperative core-needle biopsy. The data were used to select criteria for patients in whom sentinel node (SN) biopsy might be indicated.

METHODS

One hundred and seventy-one women with 172 DCIS lesions diagnosed by core-needle biopsy were analysed. Axillary staging was performed by SN biopsy, axillary node sampling, or level 1-2 axillary lymph node dissection.

RESULTS

Invasive breast cancer was found in the surgical specimens from 45 tumours (26.2 per cent). Risk factors for invasion were a palpable lesion (odds ratio (OR) 2.95 (95 per cent confidence interval 1.20 to 7.26); P = 0.019), presence of a mass on mammography (OR 3.06 (1.43 to 6.56); P = 0.004), and intermediate (OR 5.81 (1.18 to 28.57); P = 0.030) or poorly differentiated (OR 5.46 (1.17 to 25.64); P = 0.031) tumour grade. Lymph node metastases were found in ten women with DCIS and invasion on final pathology. Factors associated with metastases were age 55 years or less (P = 0.030), invasion of 1.0 cm or more (P < 0.001) and the presence of vascular invasion (P = 0.001).

CONCLUSION

SN biopsy should be considered in women with an initial diagnosis of DCIS on core-needle biopsy who are at risk for invasion; this includes women with a palpable lump, a mass on mammography, and intermediate or poor tumour grade.

Authors+Show Affiliations

Department of Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17440955

Citation

Meijnen, P, et al. "Risk of Invasion and Axillary Lymph Node Metastasis in Ductal Carcinoma in Situ Diagnosed By Core-needle Biopsy." The British Journal of Surgery, vol. 94, no. 8, 2007, pp. 952-6.
Meijnen P, Oldenburg HS, Loo CE, et al. Risk of invasion and axillary lymph node metastasis in ductal carcinoma in situ diagnosed by core-needle biopsy. Br J Surg. 2007;94(8):952-6.
Meijnen, P., Oldenburg, H. S., Loo, C. E., Nieweg, O. E., Peterse, J. L., & Rutgers, E. J. (2007). Risk of invasion and axillary lymph node metastasis in ductal carcinoma in situ diagnosed by core-needle biopsy. The British Journal of Surgery, 94(8), 952-6.
Meijnen P, et al. Risk of Invasion and Axillary Lymph Node Metastasis in Ductal Carcinoma in Situ Diagnosed By Core-needle Biopsy. Br J Surg. 2007;94(8):952-6. PubMed PMID: 17440955.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of invasion and axillary lymph node metastasis in ductal carcinoma in situ diagnosed by core-needle biopsy. AU - Meijnen,P, AU - Oldenburg,H S A, AU - Loo,C E, AU - Nieweg,O E, AU - Peterse,J L, AU - Rutgers,E J T, PY - 2007/4/19/pubmed PY - 2007/9/26/medline PY - 2007/4/19/entrez SP - 952 EP - 6 JF - The British journal of surgery JO - Br J Surg VL - 94 IS - 8 N2 - BACKGROUND: The aim of the study was to assess the risk of invasion and axillary lymph node metastasis in patients with ductal carcinoma in situ (DCIS) diagnosed by preoperative core-needle biopsy. The data were used to select criteria for patients in whom sentinel node (SN) biopsy might be indicated. METHODS: One hundred and seventy-one women with 172 DCIS lesions diagnosed by core-needle biopsy were analysed. Axillary staging was performed by SN biopsy, axillary node sampling, or level 1-2 axillary lymph node dissection. RESULTS: Invasive breast cancer was found in the surgical specimens from 45 tumours (26.2 per cent). Risk factors for invasion were a palpable lesion (odds ratio (OR) 2.95 (95 per cent confidence interval 1.20 to 7.26); P = 0.019), presence of a mass on mammography (OR 3.06 (1.43 to 6.56); P = 0.004), and intermediate (OR 5.81 (1.18 to 28.57); P = 0.030) or poorly differentiated (OR 5.46 (1.17 to 25.64); P = 0.031) tumour grade. Lymph node metastases were found in ten women with DCIS and invasion on final pathology. Factors associated with metastases were age 55 years or less (P = 0.030), invasion of 1.0 cm or more (P < 0.001) and the presence of vascular invasion (P = 0.001). CONCLUSION: SN biopsy should be considered in women with an initial diagnosis of DCIS on core-needle biopsy who are at risk for invasion; this includes women with a palpable lump, a mass on mammography, and intermediate or poor tumour grade. SN - 0007-1323 UR - https://www.unboundmedicine.com/medline/citation/17440955/Risk_of_invasion_and_axillary_lymph_node_metastasis_in_ductal_carcinoma_in_situ_diagnosed_by_core_needle_biopsy_ L2 - https://doi.org/10.1002/bjs.5735 DB - PRIME DP - Unbound Medicine ER -