PT  - JOURNAL ARTICLE
AU  - Martín Miramón, Juan Carlos
AU  - Mena, Esther
AU  - Diaz, Carmen
AU  - Martin, Amaya
AU  - Ganau, Sergi
AU  - Escribano, Fernanda
AU  - Andreu, Xavier
AU  - Sentis, Melcior
AU  - Bernà, Lluis
TI  - Sentinel lymph node biopsy in high grade ductal carcinoma in situ
DP  - 2008 May 01
TA  - Journal of Nuclear Medicine
PG  - 256P--256P
VI  - 49
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/49/supplement_1/256P.3.short
4100  - http://jnm.snmjournals.org/content/49/supplement_1/256P.3.full
SO  - J Nucl Med2008 May 01; 49
AB  - 1096 Objectives: The role of Sentinel Lymph Node (SLN) biopsy for ductal carcinoma in situ (DCIS) is unclear. Extensive and high-grade DCIS have a higher incidence of accompanying invasive foci; therefore, lymph node evaluation should be performed. We aimed to evaluate SLN biopsy in patients with high-grade DCIS. Methods: We report 19 women, mean age 58±9 y, with high-grade DCIS diagnosed by core biopsy that showed extensive microcalcifications at mammography and tumoral gadolinium enhancement at breast MRI (mean MRI tumor size 45 mm, range 7-100mm). We injected 99mTc-Nanocoll (111MBq/0.3ml) into the tumor under ultrasound (n=13) or digital stereotactic guidance (n=6) one day before surgery. All patients underwent lymphoscintigraphy 4 h after injection. Radio-guided SLN resection was performed and SLN were perioperatively analyzed by cytology and subsequently examined with immunochemistry using H&E and cytokeratin staining. Results: At least one SLN was intraoperatively identified in all patients, with a mean of 1.9 SLN/patient. Definitive histopathological examination of the tumor confirmed invasive foci associated with high-grade DCIS in 7 patients (37%): 1 with infiltrating lobular carcinoma and 6 with infiltrating ductal carcinoma. Two of the 7 patients with infiltrating carcinoma foci presented metastases in SLN (T3N2a, T1cN2a), while the remaining 17 patients had negative SLNs. Conclusions: 37% of patients diagnosed with high-grade DCIS and tumor enhancement at breast MRI had infiltrating carcinoma and SLN evaluation obviated a second surgical procedure for staging in all these patients; thus, it seems reasonable to perform SLN biopsy in this group.