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
3139 - Efficacy and safety of FOLFIRI/Aflibercept (FA) in elderly population with mCRC after failure of oxaliplatin-based chemotherapy.
Presenter: Nieves Martinez Lago
Session: Poster Display session 2
Resources:
Abstract
3446 - Fluoropyrimidine-induced cardiotoxicity in colorectal cancer patients: preliminary data from the prospective observational CHECKPOINT trial (NCT02665312)
Presenter: Pasquale Lombardi
Session: Poster Display session 2
Resources:
Abstract
3969 - Comparable survival outcome between Thai patients with sporadic young adult and adult onset colorectal cancer
Presenter: Kanjana Sukhokanjanachusak
Session: Poster Display session 2
Resources:
Abstract
4455 - Impact of primary tumor side on 3-year survival outcomes of first-line (1L) FOLFOX-4 ± cetuximab in patients with RAS wild-type (wt) metastatic colorectal cancer (mCRC) in the phase 3 TAILOR trial
Presenter: Shukui Qin
Session: Poster Display session 2
Resources:
Abstract
4481 - Undetectable RAS mutant clones in plasma: possible implication for therapy and prognosis in the patient with RAS mutant metastatic colorectal cancer?
Presenter: Mohamed Bouchahda
Session: Poster Display session 2
Resources:
Abstract
5074 - Dihydropyrimidine dehydrogenase (DPD) determination prior the administration of medicines containing fluorouracil: a single Spanish hospital experience.
Presenter: Maria Dolores Mediano Rambla
Session: Poster Display session 2
Resources:
Abstract
5242 - Differences in survival between right and left-sided colorrectal cancer (CRC) in every stage, a CARESS-CCR Group Study.
Presenter: Julia Alcaide-Garcia
Session: Poster Display session 2
Resources:
Abstract
1123 - Quality of Life (QoL) in patients with aflibercept (AFL) and FOLFIRI for metastatic colorectal cancer (mCRC) – Interim analysis with focus on mutational status of the non-interventional study QoLiTrap (AIO-LQ-0113)
Presenter: Roger von Moos
Session: Poster Display session 2
Resources:
Abstract
1212 - The cost of adverse event management in patients with RAS wild-type metastatic colorectal cancer treated with first-line cetuximab and panitumumab: an Italian healthcare payer perspective
Presenter: Karl Patterson
Session: Poster Display session 2
Resources:
Abstract
1619 - Meta-analysis of KRAS Mutation as prognostic factor in patients (pts.) with resection of colorectal (CRC) liver metastases: Tumor burden and Sideness analysis.
Presenter: Maria Romina Luca
Session: Poster Display session 2
Resources:
Abstract