Meta-analysis of sentinel node biopsy in ductal carcinoma in situ of the breast

B. Ansari (Lead / Corresponding author), S. A. Ogston, C. A. Purdie, D. J. Adamson, D. C. Brown, A. M. Thompson

    Research output: Contribution to journalArticlepeer-review

    80 Citations (Scopus)

    Abstract

    Background: The need for sentinel lymph node (SLN) biopsy in patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS) is debated. Advocates recommend such biopsy based on a high incidence of SLN involvement in some series. Opponents discourage SLN biopsy based on a perceived low incidence of nodal involvement in this setting. These contradictory arguments are generally based on small studies. The present study is a meta-analysis of the reported data on the incidence of SLN metastasis in patients with DCIS.

    Methods. A search of electronic databases identified studies reporting the frequency of SLN metastases in DCIS. The random-effects method was used to combine data.

    Results: Twenty-two published series were included in the meta-analysis. The estimate for the incidence of SLN metastases in patients with a preoperative diagnosis of DCIS was 7.4 (95 per cent confidence interval (c.i.) 6.2 to 8.9) per cent compared with 3.7 (95 per cent c.i. 2.8 to 4.8) per cent in patients with a definitive (postoperative) diagnosis of DCIS alone. This was a significant difference with an odds ratio of 2.11 (95 per cent c.i. 1.15 to 2.93).

    Conclusion: Patients with a preoperative diagnosis of DCIS should be considered for SLN biopsy.

    Original languageEnglish
    Pages (from-to)547-554
    Number of pages8
    JournalBritish Journal of Surgery
    Volume95
    Issue number5
    DOIs
    Publication statusPublished - May 2008

    Keywords

    • Core needle biopsy
    • Lymph node
    • Cancer
    • Diagnosis
    • Invasion
    • Risk
    • Predictors
    • Management
    • Recommendations
    • Positivity

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