Predictors of Invasion and Axillary Lymph Node Metastasis in Patients with a Core Biopsy Diagnosis of Ductal Carcinoma In Situ: An Analysis of 255 Cases
Predictors of Invasion and Axillary Lymph Node Metastasis in Patients with a Core Biopsy Diagnosis of Ductal Carcinoma In Situ: An Analysis of 255 Cases
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DOI：
10.1111/j.1524-4741.2011.01069.x
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发表时间：
2011-05-01
期刊：
影响因子：
2.1
通讯作者：
Sarode, Venetia
中科院分区：
文献类型：
--
作者：
Han, Jeong S.;Molberg, Kyle H.;Sarode, Venetia
导管原位癌的诊断，使用芯活检并不能确保没有入侵的最后切除。我们对255例DCIS患者进行了回顾性分析，这些患者随后进行了切除。临床、放射学和病理学发现与侵袭和前哨淋巴结（SLN）转移的风险相关。在255例DCIS患者中，199例接受了最终手术，52例（26%）在最终切除时患有浸润性导管癌（IDC）。乳腺X线检查异常微钙化的程度、影像学上可触及的肿块和DCIS的实体类型与最终切除时的浸润显著相关。前哨淋巴结活检131例（65.8%），其中18例（13.4%）有转移。IDC的大小和DCIS的范围与SLN阳性显著相关。微转移和孤立的肿瘤细胞占DCIS转移的大多数（71.4%）。对于高危DCIS患者，应考虑进行前哨淋巴结活检。
The diagnosis of ductal carcinoma in situ (DCIS) using core biopsy does not ensure the absence of invasion on final excision. We performed a retrospective analysis of 255 patients with DCIS who had subsequent excision. Clinical, radiologic, and pathologic findings were correlated with risk of invasion and sentinel lymph node (SLN) metastasis. Of 255 patients with DCIS, 199 had definitive surgery and 52 (26%) had invasive ductal carcinoma (IDC) on final excision. Extent of abnormal microcalcification on mammography, and presence of a radiologic/palpable mass and solid type of DCIS were significantly associated with invasion on final excision. Sentinel lymph node biopsy was performed in 131 (65.8%) patients of whom 18 (13.4%) had metastasis. Size of IDC and extent of DCIS on final pathology were significantly associated with positive SLN. Micrometastasis and isolated tumor cells comprised majority (71.4%) of the metastases in DCIS. SLN biopsy should be considered in those with high risk DCIS.