Abstract 5747
Background
The use of sentinel lymph node biopsy (SLNB) during breast surgery for ductal carcinoma in situ (DCIS) is controversial. It is accepted in high risk lesions (high histological grade, palpable, large >25 mm, and multifocal lesions) since it avoids a second operation if the definitive diagnosis reveals infiltrating ductal carcinoma (IDC) and its recommended due to some technical obligations in patients with planned total mastectomy or with tumor localization to the upper outer quadrant.. We aimed to evaluate the use of SLNB in patients with preoperative diagnosis of high risk DCIS lesions.
Methods
A monocentric retrospective study was conducted on 467 patients with primary diagnosed DCIS operated for partial or total mastectomy with or without SLNB. The frequency of each risk factor, and the incidence of IDC were calculated in the overall series. The predictive value of each risk factor is calculated by comparing these factors in the groups depending to the definitive pathology (IDC vs DCIS) using the chi square test. A value of p < 0.05 was considered significant.
Results
Breast surgery was done within a median of 42 ± 23 days of DCIS diagnosis. Median age was 57± 10 years. High risk DCIS lesions accounted for 73.1% of all cases (342/468). Grade III lesion, multifocal, palpable and larger than 25 mm lesions were present in 263 (56.3%), 61 (13.1%), 86 (18.4%) and 99 (21.2%) respectively. IDC was diagnosed in 95/468 patients (20.3%) in the global series and in 75patients/342 (22%) in the patients with high risk lesions. A palpable lesions and a tumor diameter >25 mm were associated with higher risk of invasive carcinoma (p = 0.007 and p = 0.017 respectively).Overall SLNB was done in 383 patients (82%), of which 318 patients (83%) had high risk lesions. A Positive SLN was detected in overall 5 patients (1.3%), all of which had high risk lesions (5/318: 1.6%).
Conclusions
In our study, the preoperative classification of high risk lesion showed a 79% sensitivity (75/95) and a 22% specificity (75/342) of detecting IDC. A positive SLN was found in only 1.6% of patients with high risk CDIS lesions operated for SLNB. The use of SLNB in patients with high risk DCIS avoids reoperation in 22% of cases. Nevertheless the low risk of positive SLN finding in this setting cannot justify its routine use.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Jean Marie Nogaret.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
869 - Impact of Education for Breast self examination in Rural Indian Women on Early Detection - results of POC study
Presenter: Sneha Parchuri
Session: Poster Display session 2
Resources:
Abstract
1951 - Breast cancer incidence and survival in renal transplant patients: 35-year experience
Presenter: Michalis Kontos
Session: Poster Display session 2
Resources:
Abstract
2017 - The changing landscape of breast cancer incidence after treatment for Hodgkin’s disease
Presenter: Amelia Benjamin
Session: Poster Display session 2
Resources:
Abstract
1780 - Number of deliveries as a prognostic factor in different breast cancer subtypes
Presenter: Anniina Jääskeläinen
Session: Poster Display session 2
Resources:
Abstract
4650 - Effects of supervised and adapted exercise program in the quality of life and strength of breast cancer survivors: MAMA MOVE Gaia trial
Presenter: Ana Joaquim
Session: Poster Display session 2
Resources:
Abstract
4962 - Study On the Socioeconomic and Clinical Factors Affecting the Proportion of Breast Conserving Surgery in Chinese Women Breast Cancer
Presenter: Jin Zhang
Session: Poster Display session 2
Resources:
Abstract
5451 - Clinical decision making and multidisciplinary team meetings (MDMs) in early breast cancer. Is the agreement between planned and applied therapeutic program?
Presenter: Marco Giavarra
Session: Poster Display session 2
Resources:
Abstract
888 - The value of genetic counselling in breast cancer genetic testing and clinical management
Presenter: Vicki Kiesel
Session: Poster Display session 2
Resources:
Abstract
4005 - Elderly patients in the Japanese Breast Cancer Registry
Presenter: Masataka Sawaki
Session: Poster Display session 2
Resources:
Abstract
3330 - Tumour-infiltrating lymphocytes and BRCA-like status in stage III breast cancer patients treated with intensified carboplatin-based chemotherapy
Presenter: Leonora De Boo
Session: Poster Display session 2
Resources:
Abstract