Is there any utility to frozen section or immunohistochemistry examination of the sentinel lymph node (SLN) in patients with ductal carcinoma in situ (DCIS)?

• DOI: 10.1200/jco.2011.29.15_suppl.1091
• Publication Date: 2017-02-23T18:58:03Z
• Authors: U. K. Ballehaninna; A. R. Reeves; R. S. Chamberlain
• Keywords: Micrometastasis; Lumpectomy

1091 Background: Whether SLN biopsy (SLNB) should be performed in patients with DCIS is controversial. Many centers perform SLNB believing it obviates the need for re-operation axillary staging when invasive cancer (IC) discovered. Given low incidence of occult IC detected, whether intra-operative pathologic evaluation during provides value has not been addressed. Methods: Demographic and clinico-pathologic data was collected analyzed all undergoing surgical resection between 2004-2010 order to determine sensitivity, specificity accuracy frozen section (FS) immuno-histochemistry (IHC) examination SLN, its’ impact on management. Results: 267 (median age 57 years) underwent lumpectomy (N=72) or mastectomy (N=195) SLNB, FS IHC evaluation. Pre-operative pathology (N=231), micro-invasion (< 2 mm, N= 24) associated other lesions (N=12). metastasis (SLNM) identified 13 (4%), which only 4 were positive (1%). micrometastasis (≤ mm) individual tumor cells (ITCs) detected by 10 patients, while 3 had macro-metastasis. Overall, 50 (19%) final pathology. The falsely negative 9 (7%), 31%, 100% 98% respectively identifying SLNM. 8 SLNM lymph node dissection (ALND) 1 patient (with macro-metastasis) further metastasis. On a treat basis, 30 91 would have undergo exam identify Conclusions: uncommon prognostic significance micro-metastasis ITCs unknown. infrequent higher nodal involvement sensitivity yield particularly candidates ALND, these procedures can safely omitted thereby reducing operative time cost. Additional studies are needed validate results.