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All TopicsForum: DCIS (Ductal Carcinoma In Situ) → Topic: Sentinel Node and DCIS

Topic: Sentinel Node and DCIS

Forum: DCIS (Ductal Carcinoma In Situ) — Just diagnosed, in treatment, or finished treatment for DCIS.

Posted on: Jun 28, 2012 05:54PM

Hoya03mom wrote:

I was curious as to how many women who have DCIS and/or other "pre-cancer" pappaloma etc had a sentinel node test that did not show any cancer.  My doctors keep telling me what I have is not invasive, stage 0, but since there is so much on the RT side and several "pre-cancer" spots on the left I have decided on having a double mastectomy.  In conjunction with that they are doing the node surgery and will get an initial pathology report.  If they (both sides...UGH) come back clean, and breast pathology shows no invasion, then I am done (except for the fun of reconstruction).  No chemo, radiation or hormones.  That would be a triple win in my book.  MD's say they don't expect to find anything in nodes, but I wondered what % of DCIS had something show up.  Hope I am stating my question clearly...so new to this wonderful world of cancer!!

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Jun 28, 2012 06:24PM Anne888 wrote:

My DCIS "adventure" was 11 years ago, and I requested a sentinel node biopsy although SNBs were not done for DCIS back then. The  3 nodes were negative because I had only DCIS.  Since DCIS is by definition, non-invasive (stage 0), it cannot travel to your lymph nodes (or anywhere else).  However, sometimes there is invasive cancer hiding in there with the DCIS, and that could conceivably travel to the nodes.  If you have just DCIS, there is 0% chance of it showing up in the nodes.

Dx 3/2001, DCIS, <1cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2+
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Jun 28, 2012 07:42PM, edited Jun 28, 2012 07:48PM by maize

Hi Hoya02mom,

From one study:

The Role of Sentinel Lymph Node Biopsy in Patients With Ductal: Ductal Carcinoma In Situ and Sentinel Lymph Node Biopsy

"Experts at MCC and our center believe that if SLN biopsy is not carried out at the initial operation, then 10% to 21% of DCIS patients will require a second operation to evaluate their regional lymph nodes because of previously undetected infiltrating ductal carcinoma."

The significance of DCIS with an occult focus of microinvasive disease has not been determined. Prior studies from the Memorial Sloan-Kettering Cancer Center found invasive disease in 12 (11%) of 110 patients undergoing mastectomy for DCIS.[7] Other studies have found residual invasive disease in 21% of mastectomy specimens after a previous diagnostic breast biopsy revealed pure DCIS.[8,9]

http://www.medscape.com/viewarticle/487388_2

A lot of women have no invasive disease in the nodes..the above study found that 98 of 110 women didn't have any micro-cancers in the lymph nodes. As I understand it, it's common to do SNB if there's any question at all about it. Best of luck to you.

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Jun 28, 2012 07:55PM BLinthedesert wrote:

It is my understanding that is common to do sentinel node biopsies with MX (for DCIS), because once you remove the breast tissue there are no sentinel nodes ... so it would be the only time they can find them.  They will always do SNB with invasive breast cancer, even if lumpectomy is performed.

Dx 3/15/2012, DCIS, 1cm, Stage 0, Grade 2, ER-/PR-Surgery 04/20/2012 Lumpectomy (Right)Radiation Therapy 05/21/2012 External
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Jul 4, 2012 06:47PM NanG wrote:

My ONC said that with all mast. now they do snb.  because they are in there, they are taking them anyways, and they will have the data for pathology.  i think even if they are doing lumpectomy now they are doing snb?  from all the other girls ive talked with everyone has snb unless they don't have surgery...so far....that ive talked to anyways.

Dx 4/25/2012, DCIS, 6cm+, Stage 0, Grade 2, 0/2 nodes, HER2-Surgery 06/18/2012 Mastectomy (Right); Lymph Node Removal (Right); Prophylactic Mastectomy (Left); Reconstruction: Tissue expander placement (Both)Surgery 12/17/2012 Reconstruction: Breast implants (permanent) (Both)
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Jul 4, 2012 07:51PM akinto wrote:

Not standard of practice in Canada, AFAIK.

Dx 4/5/2012, DCIS, Stage 0, Grade 3, 0/0 nodes, ER+/PR+
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Jul 4, 2012 07:54PM BLinthedesert wrote:

Here in the US, snb is only done for DCIS if a mx is performed. If there is microinvasion then it is stage 1 and snb is performed for all stage 1 and above.

Dx 3/15/2012, DCIS, 1cm, Stage 0, Grade 2, ER-/PR-Surgery 04/20/2012 Lumpectomy (Right)Radiation Therapy 05/21/2012 External