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The role of sentinel node biopsy in ductal carcinoma in situ of the breast.

机译:前哨淋巴结活检在乳腺导管癌中的作用。

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AIM: Sentinel node biopsy (SNB) is an accepted alternative to lymphadenectomy in the case of invasive breast carcinoma, although the sentinel node's role in ductal carcinoma in situ (DCIS) diagnosed on core needle biopsy has not been well defined nevertheless guidelines recommend this procedure. The purpose of this study was to determine the diagnostic value of sentinel nodes in female patients with primary DCIS using core needle stereotactic biopsy. MATERIAL AND METHODS: Between the years 2000 and 2005, 261 patients were diagnosed with DCIS by core needle biopsy. In this group, 183 patients underwent SNB to determine lymph node involvement. Those patients with metastases to the sentinel node underwent axillary lymphadenectomy. RESULTS: In the group of 183 patients that underwent SNB, 10 patients (5.5%) showed metastases to the sentinel lymph node. Histopathological studies of the primary lesions of these 10 patients revealed invasive ductal carcinoma in 6 cases (3.5%) and 1 case (0.5%) of invasive lobular carcinoma. Only 3 of the patients (1.5%) were given a final diagnosis of DCIS with metastases to sentinel lymph nodes, of which 2 cases were DCIS and 1 case was DCIS with microinvasion. Axillary lymphadenectomy performed on patients with abnormal SNB showed involvement of other axillary lymph nodes in 4 patients. CONCLUSIONS: SNB as a diagnostic tool in DCIS remains controversial as the number of cases of axillary lymph node metastases is minuscule. The biggest clinical challenge in this situation is a group of patients with primary diagnosis of DCIS in which invasive components are seen by mammotomic biopsy.
机译:目的:在浸润性乳腺癌的情况下,前哨淋巴结活检(SNB)是淋巴结清扫术的一种公认的替代方法,尽管尚未明确定义在核心针头活检中诊断出的前哨淋巴结在导管原位癌(DCIS)中的作用,但指南仍推荐此方法。这项研究的目的是确定使用核心针立体定位活检对女性原发性DCIS患者的前哨淋巴结的诊断价值。材料与方法:在2000年至2005年之间,有261例经芯针穿刺活检诊断为DCIS。在该组中,有183例患者接受了SNB以确定是否有淋巴结受累。那些转移至前哨淋巴结的患者接受了腋窝淋巴结清扫术。结果:在接受SNB的183例患者中,有10例(5.5%)显示出前哨淋巴结转移。对这10例患者的原发灶的组织病理学研究显示,浸润性导管癌6例(3.5%)和1例(0.5%)浸润性小叶癌。仅有3例(1.5%)患者被诊断为DCIS前哨淋巴结转移,其中DCIS 2例,微浸润DCIS 1例。对SNB异常的患者进行的腋窝淋巴结清扫术显示有4例患者累及其他腋窝淋巴结。结论:SNB作为DCIS的诊断工具仍然存在争议,因为腋窝淋巴结转移的病例很少。在这种情况下,最大的临床挑战是​​一组初步诊断为DCIS的患者,其中通过乳腺活检发现侵入性成分。

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