Sentinel Lymph Node Metastasis in Microinvasive Breast Cancer

Intra, Mattia; Zurrida, Stefano; Maffini, Fausto; Sonzogni, Angelica; Trifirò, Giuseppe; Gennari, R; Arnone, Paolo; Bassani, G; Opazo, Antonio; Paganelli, Giovanni; Viale, Giuseppe; Veronesi, Umberto

doi:10.1245/aso.2003.04.009

Cited by 77 publications

(34 citation statements)

References 23 publications

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“…Also the differences in the histopathological assessment of the SN metastases certainly influence the results. As regards to microinvasive DCIS, our 9% prevalence of tumourpositive SN findings is in agreement with the findings of previous studies [3,5,18].…”

Section: Discussionsupporting

confidence: 93%

Tumour‐positive sentinel node findings in patients with ductal carcinoma in situ

Leidenius

Salmenkivi

Smitten

et al. 2006

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 93%

Tumour‐positive sentinel node findings in patients with ductal carcinoma in situ

Leidenius

Salmenkivi

Smitten

et al. 2006

Journal of Surgical Oncology

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“…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). There has been a lack of agreement in the literature as to whether DCISM should be considered and treated simply as a stage 0 DCIS lesion (Cavaliere et al, 2006), or instead as a small invasive cancer (Intra et al, 2003). According to various studies, the rate of imaging appearance of DCISM lesions as masses with or without associated calcifications on mammography range between 17% and 57% (Vieira et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

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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“…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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Sentinel Lymph Node Metastasis in Microinvasive Breast Cancer

Cited by 77 publications

References 23 publications

Tumour‐positive sentinel node findings in patients with ductal carcinoma in situ

Tumour‐positive sentinel node findings in patients with ductal carcinoma in situ

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Microinvasive Carcinoma of the Breast

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