Clinical Significance of Van Nuys Prognostic Index As A Qualification Criterion to Sentinel Lymph Node Biopsy in Patients Diagnosed with Ductal Carcinoma in Situ
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Diagnose of ductal carcinoma in situ (DCIS) requires, at least in a part of cases, assessment of auxiliary lymph nodes.The aim of the study was to analyze clinical value of Van Nuys Prognostic Index (VNPI) as the important criterion for qualification of DCIS patients to sentinel lymph node biopsy (SLNB).Material and methods. Analysis included patients diagnosed with DCIS and qualified to SLNB, operated in years 2004-2013. We performed a statistical analysis to assess correlation between VNPI value and positive pathological verification of excised sentinel lymph node (SLN). The influence of other clinical factors on presence of metastases in SLN was also determined.Results. 3,6% of DCIS patients were diagnosed with metastases in SLN. Metastases were diagnosed in 6.7% patients with VNPI > 10 points vs 3.4% in patients with VNPI < 10 points. In 75% of patients with metastatic SLN the value of VNPI was at least 10 points.In premenopausal patients metastases in SLN were diagnosed in 8.1% of cases vs 1.4% in postmenopausal patients. In patients diagnosed with cancer of the other breast metastases in SLN were found in 6.3% of cases vs 3.2% in one-sided cancer. Patients with multifocal cancer were over twice as often diagnosed with metastases in SLN (5% vs 2%). There was no correlation found between VNPI value and positive pathological verification of SLN. No differences between prevalence of SLN metastases depending on selected clinical features were found.Conclusions. Recommendation of VNPI as the criterion of qualification to SLNB starting with 10 points could be more favourable in patients with DCIS. Deciding on SLNB in DCIS patients, we should also take into consideration other clinical features.
3 - 2 - 2015
6 - 8 - 2014
- Department of Breast Cancer and Reconstructive Surgery, Oncology Center in Bydgoszcz Koordynator: dr n. med., email@example.com
- Department of Clinical Oncology, Oncology Center in Bydgoszcz Koordynator: dr n. med.
- Outpatient Chemotherapy Department, Oncology Center in Bydgoszcz Koordynator: dr n. med.
- Surgical Oncology Clinic, Collegium Medicum Nicolaus Copernicus University, Oncology Center in Bydgoszcz Kierownik: prof. dr hab.
- 1. Yi M, Krishnamurthy S, Kuerer HM: et al.: Role of primary tumor characteristics in predicting positive sentinel lymph nodes in patients with ductal carcinoma in situ or microinvasive breast cancer. Am J Surg 2008; 196(1): 81-87.
- 2. Jemal A, Siegel R, Ward E et al.: Cancer statistics, 2006. CA Cancer J Clin 2006; 56(2): 106-30.
- 3. Greene FL: American Joint Committee on Cancer, American Cancer Society, AJCC. Cancer Staging Manual, 6th ed. New York: Springer-Verlag 2002.
- 4. Lippman M: Why study ductal carcinoma in-situ? W: Silverstein MJ, Recht A, Lagios M (red.). Ductal carcinoma in-situ of the breast 2nd ed., Philadelphia: Lippincott William and Wilkins; 2002, s: 12-16.
- 5. Erbas B, Provenzano W, Armes J, Gertig D: The natural history of ductal carcinoma in situ of the breast: a review. Breast cancer res Treat 2006; 97(2): 135-44.
- 6. Silverstein MJ, Skinner KA, Lomis TJ: Predicting axillary nodal positivity in 2282 patients with breast carcinoma. world J surg 2001; 25(6): 767-72.[PubMed]
- 7. Kelly Ta, Kim Ja, Patrick R et al.: Axillary lymph node metastases in patients with a final diagnosis of ductal carcinoma in situ. Am J surg 2003; 186(4): 368-70.
- 8. Adamovich Tl, simmons RM: Ductal carcinoma in situ with microinvasion. Am J surg 2003; 186(2): 112-16.
- 9. Silverstein MJ, Waisman JR, Gamagami P et al.: Intraductal carcinoma of the breast (208 cases). Clinical factors influencing treatment choice. cancer 1990; 66(1): 102-08.
- 10. Jassem J, Krzakowski M (red.): Rak piersi. W: Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych. Krzakowski M i wsp. (red.). Onkologia w Praktyce Klinicznej, Warszawa 2011; 7, supl. B: 197246.
- 11. Silverstein MJ: The University of Southern California/Van Nuys prognostic index for DCIS of the breast. Am J surg 2003; 186(4): 337-43.
- 12. wong SL, Edwards MJ, Chao С et al.: The effect of prior breast biopsy method and concurrent definitive breast procedure on success and accuracy of sentinel lymph node biopsy. Ann surg oncol 2002; 9(3): 272-77.[Crossref][PubMed]
- 13. sakr R, Bezu c, Raoust I et al.: The sentinel lymph node procedure for patients with preoperative diagnosis of ductal carcinoma in situ: risk factors for unsuspected invasive disease and for metastatic sentinel lymph nodes. int J clin Pract 2008; 62(11): 1730-35.[WoS]
- 14. Bruening W, Fontanarosa J, Tipton К et al.: Systematic review: comparative effectiveness of core-needle and open surgical biopsy to diagnose breast lesions. Апп intern Med 2010; 152(4): 238-46.
- 15. Murphy CD, Jones JL, Javid SH: Do sentinel node micrometastases predict recurrence risk in ductal carcinoma in situ and ductal carcinoma in situ with microinvasion? Am J Surg 2008; 196(4): 566-68.
- 16. Kumar S, Sacchini V: The surgical management of ductal carcinoma in situ. Breast J 2010; 16: 49-52.[WoS][Crossref]
- 17. Estévez LG, Alvarez I, Seguí MÁ et al.: Current perspectives of treatment of ductal carcinoma in situ. Cancer Treat Rev 2010; 36(7): 507-17.[Crossref][PubMed]
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