CGSO National Videoconference: Breast Disease (2020)-Is sentinel lymph node biopsy indicated in patients with a diagnosis of ductal carcinoma in situ? A systematic literature review and meta-analysis

Is sentinel lymph node biopsy indicated in patients with a diagnosis of ductal carcinoma in situ? A systematic literature review and meta-analysis

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A recent systematic literature review and meta-analysis investigated whether sentinel lymph node biopsy (SLNB) is indicated in patients with a diagnosis of ductal carcinoma in situ (DCIS). The review included 48 studies with a total of 9,803 DCIS patients who underwent SLNB. The analysis found that the percentage of positive SLNBs was higher in patients with a preoperative diagnosis of DCIS compared to those with a postoperative diagnosis. The mean percentage of positive SLNBs was 5.95% in the preoperative group and 3.02% in the postoperative group. Meta-regression analysis showed that larger tumor size and higher grade were significantly associated with positive SLNB results. However, there was no association between age at diagnosis or upstage rate and SLNB positivity. The study concluded that SLNB should be routinely considered in patients with large (>2 cm) high-grade DCIS, but is not routinely indicated for low- and intermediate-grade DCIS, high-grade DCIS smaller than 2 cm, or pure DCIS diagnosed by surgical excision. However, the study acknowledged limitations including variations in histological analysis among studies, lack of data on the type of core biopsy used, and the need for further research on the clinical implications of a positive SLNB in DCIS patients.

Keywords

sentinel lymph node biopsy

SLNB

ductal carcinoma in situ

DCIS

systematic literature review

meta-analysis

positive SLNB

tumor size

tumor grade

core biopsy