Beneficio de la biopsia del ganglio linfático centinela en pacientes con carcinoma in situ de mama

Introduction

Patients with a diagnosis of breast ductal carcinoma in situ (DCIS) have a low risk of developing axillary metastases. The use of sentinel node biopsy in this group of patients is controversial. The objective of this study is to determine if the sentinel node biopsy benefits a subgroup of patients with DCIS.

Patients and method

Between April 2002 and December 2007, patients with a diagnosis of DCIS and who underwent a sentinel node biopsy were included in the study. In our centre the sentinel node biopsy was performed in patients with DCIS who required a mastectomy, high grade and >2 cm DCIS and palpable DCIS.

Results

Forty-seven patients were included in the study. In all cases the sentinel node was identified. Twenty-five (53.1%) patients underwent a mastectomy due to extensive DCIS; 14 of these (56%) with immediate reconstruction with implants. Twenty-five (53.1%) patients had high grade DCIS. In 7 (14.8%) patients the tumour was palpable. Fourteen patients (29.7%) were upgraded to invasive breast cancer in the definitive histology. In 2 (4.2%) patients who underwent a mastectomy a positive sentinel node was found.

Conclusions

Performing sentinel node biopsy in this group of DCIS patients has lead us to identify 4% of patients with positive sentinel nodes. Furthermore, 29.7% of the patients have avoided a second invasive diagnostic procedure for definitive histology. For these reasons we consider it appropiate to perform sentinel node biopsy in this subgroup of patients with DCIS of the breast.