当核心活检显示导管原位癌时，乳腺癌前哨淋巴结活检的适应证。

Indication for sentinel lymph node biopsy for breast cancer when core biopsy shows ductal carcinoma in situ.

机构信息

Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Suita, Japan.

出版信息

Am J Surg. 2011 Jul;202(1):59-65. doi: 10.1016/j.amjsurg.2010.09.032.

DOI:10.1016/j.amjsurg.2010.09.032

PMID:21741518

Abstract

BACKGROUND

The use of sentinel lymph node biopsy (SLNB) for ductal carcinoma in situ (DCIS) is controversial.

METHODS

A total of 103 primary breast cancer patients who were diagnosed with DCIS by needle biopsy preoperatively and underwent initial SLNB were analyzed retrospectively.

RESULTS

No sentinel nodal metastasis was detected in 66 patients with the final diagnosis of DCIS. However, 2 (5.4%) of 37 patients with invasive ductal carcinoma at final diagnosis had positive sentinel nodes. Multivariate logistic regression analysis identified 2 independent significant predictors of existence of invasive components: presence of a palpable tumor (odds ratio, 4.091; 95% confidential interval, 1.399-11.959; P = .010) and tumor size of 2.0 cm or larger on magnetic resonance imaging (odds ratio, 4.506; 95% confidence interval, 1.322-15.358; P = .016).

CONCLUSIONS

Initial SLNB should be considered for patients diagnosed with DCIS by needle biopsy when they have a high risk for harboring invasive ductal cancer preoperatively.

摘要

背景

前哨淋巴结活检（SLNB）在导管原位癌（DCIS）中的应用存在争议。

方法

回顾性分析了 103 例术前经针吸活检诊断为 DCIS 并接受初始 SLNB 的原发性乳腺癌患者。

结果

最终诊断为 DCIS 的 66 例患者中未发现前哨淋巴结转移。然而，最终诊断为浸润性导管癌的 37 例患者中有 2 例（5.4%）前哨淋巴结阳性。多因素逻辑回归分析确定了存在浸润成分的 2 个独立显著预测因子：可触及肿瘤的存在（比值比，4.091；95%置信区间，1.399-11.959；P =.010）和磁共振成像上的肿瘤大小为 2.0 cm 或更大（比值比，4.506；95%置信区间，1.322-15.358；P =.016）。