Rafael da Silva Sá, Roberto Hernandes Giordano, Ângela Flávia Logullo Waitzberg, Vanessa Monteiro Sanvido, Joaquim Teodoro de Araújo Neto, Simone Elias, Gil Facina, Afonso Celso Pinto Nazário
Institution: Federal University of São Paulo / Paulista School of Medicine
Objectives: Ductal carcinoma in situ (DCIS) is characterized by proliferation of ductal epithelium without invasion through the basement membrane. With the increasing use of mammography, there has been a marked increase in the detection of DCIS. Silverstein et al reported less positive than 1% in patients suffering from DCIS who underwent axillary dissection. However, the axillary evaluation remains a routine in some hospitals. The main objective of the study was to analyze, retrospectively, the positivity of sentinel node biopsy (SNB) in patients with DCIS and the predictive value of minimally invasive biopsies. Methodology: We review patient’s medical records with DCIS in outpatient Mastology of Federal University of São Paulo between 2009 and 2013. SNB was perform when mastectomy is planned or when there was ?high risk? for invasion (physical examination or imaging shows a mass lesion highly suggestive of invasive cancer, when the area of DCIS by imaging is large 􏰇4 cm or high nuclear grade). Results: 129 patients were carriers of DCIS and 69 were subjected to SNB. The mean age was 57.2 years and 71.2% of patients were postmenopausal women. Microcalcifications alone was the primary lesion in 72%. The core biopsy was performed in 68.8% of cases. Underestimation was seen in 22.3% (52.3% invasive ductal carcinoma, 33.3% microinvasive carcinoma, 9.4% invasive papillary carcinoma and 4.7% invasive lobular carcinoma). The sentinel node was negative in 95.7%. In all cases of SN positive (4.3%) the index lesion was nodular, solid histological pattern of DCIS and the surgery was mastectomy. Conclusion: Women with a minimally invasive biopsy showing DCIS who are being treated with breast conserving surgery, there is no evidence to support performing SNB. This technique should be discouraged due to its low positivity and high rates of complications. Keywords: breast neoplasms, biopsy, ultrasonograph interventional, sentinel lymph node biopsy, Apresentação por Afonso Celso