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Sentinel Lymph Node Examination in Breast Carcinoma in Situ


Authors: Ja. Mergancová;  Ji. Mergancová;  I. Hrnčířová 1;  Z. Kerekes 2;  M. Hácová 3
Authors‘ workplace: Chirurgická klinika, Pardubická krajská nemocnice a. s., přednosta: doc. MUDr. Jiří Šiller, Ph. D. ;  Mamodiagnostické centrum Pardubice s r. o. 1;  Patologie Litomyšl 2;  Patologicko-anatomické oddělení, Pardubická krajská nemocnice a. s., primář: MUDr. Pavel Rothröckel 3
Published in: Rozhl. Chir., 2011, roč. 90, č. 7, s. 393-396.
Category: Monothematic special - Original

Overview

Introduction:
Breast carcinoma in situ is defined as non-invasive form of carcinoma. However, we can see infiltration of sentinel lymph node even in this disease. The aim of this work was to determine indication criteria for detection of sentinel lymph node in breast carcinoma in situ.

Materials and methods:
Summary of current knowledge about examination of sentinel lymph node in breast carcinoma in situ. Comparison of the results with our own results.

Results:
We summarized the results of 10 trials studying ductal carcinoma in situ (DCIS) and 4 studies with DCIS with microinvasion. Sentinel lymph node infiltration is described in 0 to 7.3%, or 9.3 to 29.4%. In our department during the period of one year, we diagnosed 7 carcinomas in situ, in the final histology examination 5 DCIS, 1 DCIS with microinvasion and 1 lobular carcinoma in situ (LCIS) with microinvasion. Sentinel lymph node infiltration was diagnosed only in LCIS with microinvasion. The other, non-sentinel axillary lymph nodes, were negative in this patient. The indication criteria for sentinel lymph node examination in breast carcinoma in situ in our department include: greater extent of microcalcifications, indication for total mastectomy for diffuse involvement, microcalcifications with palpable resistance, preoperative diagnosis of carcinoma in situ from core-cut biopsy, carcinoma in situ G3 confirmed in open extirpation.

Conclusions:
The sentinel lymph node examination in breast carcinoma in situ can change staging of the disease, as well as the treatment modality. In case that the sentinel lymph node is positive, the disease is undoubtedly invasive and the invasive part of the tissue was not seen in the biopsy sample.

Key words:
in situ breast cancer – sentinel node – microcalcification


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