수술 전 관상피내암으로 진단된 환자에서의 감시림프절 생검을 고려해야 하는 위험인자들에 대한 고찰

김진주; 엄용화; 채병주; 송병주; 정상설

doi:http://dx.doi.org/10.14449/jbd.2015.3.2.48

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자료유형: 학술저널

저자정보: 김진주 (가톨릭대학교 의과대학 외과학교실) 엄용화 (가톨릭대학교 의과대학 외과학교실) 채병주 (가톨릭대학교 의과대학 외과학교실) 송병주 (가톨릭대학교 의과대학 외과학교실) 정상설 (가톨릭대학교 의과대학 외과학교실)

저널정보: 한국유방암학회 Journal of Breast Disease Journal of Breast Disease 제3권 제2호

발행연도: 2015.12

수록면: 48 - 55 (8page)

DOI: http://dx.doi.org/10.14449/jbd.2015.3.2.48

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Purpose: Sentinel lymph node (SLN) biopsy has become the gold standard for axillary staging of invasive breast cancer. However, some controversy has existed concerning the usefulness of SLN biopsy in ductal carcinoma in situ (DCIS). In this study, we tried to identify the usefulness of SLN biopsy in patients with an initial preoperative diagnosis of DCIS. Methods: A retrospective analysis was performed using single-center data of 415 patients with an initial diagnosis of DCIS between January 2003 and December 2013. Many features were correlated with upstaging and positive SLN biopsy using univariate analysis and multivariate analysis. Results: A total of 415 patients with a preoperative diagnosis of DCIS were enrolled in this study. Total 320 of 415 patients (77.1%) underwent axillary evaluation via SLN biopsy, axillary lymph node dissection, or additional axillary lymph node dissection, and 24 of 320 patients (7.5%) were diagnosed with axillary lymph node metastasis or micrometastases in the lymph nodes. Of 415, 296 patients (71.3%) underwent SLN biopsy and 16 patients (5.4%) had positive SLN biopsy. The rate of upstaging to invasive cancer was 4.1% (17 of 415 patients) on final pathology. Of the 17 patients who were upstaged to invasive carcinoma at final pathology, seven patients (41.2%) had a positive SLN biopsy. The statistically significant factors of upstaging were large tumor size (≥2 cm), histologic features of intermediate or high-grade tumor, and positive SLN biopsy. Conclusion: SLN biopsy should be considered in patients with high risk DCIS as a part of the primary surgical procedure.

#Breast #Noninfiltrating intraductal carcinoma #Sentinel lymph node biopsy

참고문헌 (23)

참고문헌 신청

Francis AM / 2015 / Is sentinel lymph node dissection warranted for patients with a diagnosis of ductal carcinoma in situ? / Ann Surg Oncol 22:4270~4279

Boxer MM / 2013 / A review of the management of ductal carcinoma in situ following breast conserving surgery / Breast 22:1019~1025

Mokbel K / 2003 / Towards optimal management of ductal carcinoma in situ of the breast / Eur J Surg Oncol 29:191~197

Mabry H / 2006 / What is the value of axillary dissection or sentinel node biopsy in patients with ductal carcinoma in situ? / Am J Surg 192:455~457

Kim J / 2012 / Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy to invasive cancer in subsequent surgical excision / Breast 21:641~645

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