The American Journal of Surgery
Volume 184, Issue 4 , Pages 348-349, October 2002

Do not contemplate invasive surgery for ductal carcinoma in situ

Presented at the Third Annual Meeting of the American Society of Breast Surgeons, Boston, Massachusetts, April 24–28, 2002

  • John J Zelis, M.D.

      Affiliations

    • Department of Surgery, Grant Medical Center, Columbus, OH, USA
    • Department of Medical Education, Grant Medical Center, 111 South Grant Ave., Columbus, OH 43215, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-614-461-3264; fax: +1-614-461-3709.
    • ,
  • Brenda J Sickle-Santanello, M.D.

      Affiliations

    • Department of Surgery, Grant Medical Center, Columbus, OH, USA
    • ,
  • Wen C Liang, D.O.

      Affiliations

    • Department of Surgery, Grant Medical Center, Columbus, OH, USA
    • ,
  • Thomas A Nims, M.D.

      Affiliations

    • Department of Surgery, Grant Medical Center, Columbus, OH, USA

Received 6 May 2002; received in revised form 27 May 2002

Abstract 

Background

Ductal carcinoma in-situ (DCIS), by definition, has no metastatic potential. The routine examination of axillary lymph nodes in these patients may expose them to unnecessary operative morbidity and is the subject of continuing controversy. This study evaluates the lymph node status of patients with DCIS.

Methods

A retrospective review of all tumor registry patients diagnosed with DCIS between January 1996 and December 2000 was performed. Data obtained included (1) patient demographics, (2) the surgical procedure performed, (3) the histologic grade of the tumor, and (4) the lymph node status, if obtained. All analysis was by hematoxylin and eosin (H&E) stain only.

Results

In all, 380 patients were diagnosed with DCIS. Surgical therapy for these patients varied from lumpectomy (with negative margins) to modified radical mastectomy. Ninety-seven (25.5%) had their axillary lymph nodes (average 9, range 1 to 33) analyzed by H&E stain and are the subject of this study. One patient (1%) was found to have a lymph node micrometastasis.

Conclusions

This study demonstrates that axillary lymph node examination is a low-yield endeavor for patients diagnosed with DCIS, regardless of the histologic grade of the tumor. Routine sampling of lymph nodes in these patients is not warranted.

Keywords:  Axillary dissection, Ductal carcinoma in situ, Lymph node

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PII: S0002-9610(02)00946-7

The American Journal of Surgery
Volume 184, Issue 4 , Pages 348-349, October 2002

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