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Vol. 99. Issue 9.
Pages 655-659 (November 2021)
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Vol. 99. Issue 9.
Pages 655-659 (November 2021)
Original article
Underestimation of invasive breast carcinoma in patients with initial diagnosis of ductal carcinoma in situ: Size matters
Infraestimación de carcinoma infiltrante de mama en pacientes con diagnóstico inicial de carcinoma ductal in situ: el tamaño importa
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Alberto Bouzón Alejandroa,
Corresponding author
dr.alberto@aecirujanos.es

Corresponding author.
, Ángela Iglesias Lópezb, Benigno Acea Nebrila, María Lourdes García Jiméneza, Carlota Czestokowa Díaz Carballadac, José Ramón Varela Romerob
a Department of Surgery, Breast Unit, Complejo Hospitalario Universitario A Coruña, Spain
b Department of Radiology, Breast Unit, Complejo Hospitalario Universitario A Coruña, Spain
c Department of Obstetrics & Gynecology, Breast Unit, Complejo Hospitalario Universitario A Coruña, Spain
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Tables (2)
Table 1. Clinical and tumoral characteristics (n = 105).
Table 2. Predictors of upstaging to invasive disease. Univariate analysis.
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Figures (1)
Abstract
Background

The aim of our study was to identify those patients with preoperative diagnosis of ductal carcinoma in situ (DCIS) and high risk of upstaging to invasive breast carcinoma (IBC), in whom sentinel lymph node biopsy (SLNB) should be considered.

Materials and methods

One-hundred and five DCIS patients treated with breast-conserving surgery (BCS) or mastectomy were studied. Preoperative features of the tumours were analyzed to investigate its association with underestimation of IBC on final pathology.

Results

Overall, the underestimation rate of IBC was 16.2%. The underestimation rate was highest in lesions with initial size >2 cm compared with those with size ≤2 cm (26.8% vs. 4.1%, respectively; p < 0.003). Eighty-eight patients (83.8%) underwent concurrent SLNB and only one case had lymph node involvement (1.1%).

Conclusions

SLNB should be considered in DCIS patients receiving BCS with lesions greater than 2 cm since approximately one in four will harbour an IBC.

Keywords:
Ductal carcinoma in situ
Invasive breast carcinoma
Sentinel lymph node biopsy
Breast-conserving surgery
Resumen
Introducción

El objetivo de nuestro estudio consistió en identificar aquellas pacientes con diagnóstico preoperatorio de carcinoma ductal in situ (CDIS) y alto riesgo de presentar un carcinoma infiltrante en la lesión, en las que se debería considerar realizar una biopsia selectiva de ganglio centinela (BSGC).

Métodos

Se estudiaron 105 pacientes con CDIS tratadas mediante cirugía conservadora o mastectomía. Se analizaron las características preoperatorias de los tumores para investigar su asociación con la infraestimación de carcinoma infiltrante.

Resultados

El porcentaje global de infraestimación de carcinoma infiltrante fue del 16,2%. El porcentaje de infraestimación fue mayor en las lesiones con un tamaño inicial superior a 2 cm en comparación con las lesiones con un tamaño igual o menor a 2 cm (26,8% vs. 4,1%, respectivamente; p < 0,003). Se realizó la BSGC en ochenta y ocho pacientes (83,8%), encontrándose afectación ganglionar en un solo caso (1,1%).

Conclusiones

En pacientes con diagnóstico inicial de CDIS tratadas mediante cirugía conservadora, se debería considerar realizar una BSGC cuando el tamaño de la lesión es superior a 2 cm, ya que uno de cada cuatro casos albergará la presencia de un carcinoma infiltrante.

Palabras clave:
Carcinoma ductal in situ
Carcinoma de mama invasivo
Biopsia de ganglio linfático centinela
Cirugía conservadora de mama

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