Could sentinel lymph node biopsy be exempted for ductal carcinoma in situ after mastectomy?

摘要

I want to congratulate Dr. Watanabe et al. for their study on the upstaging to invasive ductal carcinoma (IDC) after mastectomy for ductal carcinoma in situ (DCIS) [1]. They reported that 22.6% of 226 DCIS lesions were upgraded to IDC after mastectomy, and the prevalence of macrometastasis of sentinel lymph nodes (SLNs) was 0.9%. I would like to make two comments on this study. First, the authors believed SLN biopsy for patients undergoing mastectomy with a preoperative diagnosis of DCIS was overtreatment based on the fact that the prevalence of SLN metastasis was low and the long-term outcome was excellent.