Underestimation of invasive breast carcinoma in patients with initial diagnosis of ductal carcinoma in situ: Size matters

Alberto Bouzón Alejandro; Ángela Iglesias López; Benigno Acea Nebril; María Lourdes García Jiménez; Carlota Czestokowa Díaz Carballada; José Ramón Varela Romero

doi:10.1016/j.ciresp.2020.10.020

Underestimation of invasive breast carcinoma in patients with initial diagnosis of ductal carcinoma in situ: Size matters

Cir Esp (Engl Ed). 2021 Feb 1:S0009-739X(20)30350-X. doi: 10.1016/j.ciresp.2020.10.020. Online ahead of print.

[Article in English, Spanish]

Authors

Alberto Bouzón Alejandro¹, Ángela Iglesias López², Benigno Acea Nebril³, María Lourdes García Jiménez³, Carlota Czestokowa Díaz Carballada⁴, José Ramón Varela Romero²

Affiliations

¹ Unidad de Mama, Servicio de Cirugía General, Complejo Hospitalario Universitario A Coruña, España. Electronic address: dr.alberto@aecirujanos.es.
² Unidad de Mama, Servicio de Radiología, Complejo Hospitalario Universitario A Coruña, España.
³ Unidad de Mama, Servicio de Cirugía General, Complejo Hospitalario Universitario A Coruña, España.
⁴ Unidad de Mama, Servicio de Ginecología, Complejo Hospitalario Universitario A Coruña, España.

PMID: 33541705
DOI: 10.1016/j.ciresp.2020.10.020

Abstract

Introduction: 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.

Methods: One-hundred and five DCIS patients treated with breast-conserving surgery (BCS) or mastectomy were studied. Preoperative features of the tumors 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 harbor an IBC.

Keywords: Biopsia selectiva de ganglio centinela; Breast-conserving surgery; Carcinoma ductal in situ; Carcinoma infiltrante de mama; Cirugía conservadora de mama; Ductal carcinoma in situ; Invasive breast carcinoma; Sentinel lymph node biopsy.