[In situ mammary duct carcinoma with microinvasion. Which axillary lymph node exploration?]

Presse Med. 2005 Feb 12;34(3):208-12. doi: 10.1016/s0755-4982(05)88249-1.
[Article in French]


Objective: Specify the role of axillary lymph node removal in micro-invasive in situ duct carcinomas (DCIS-MI) of the breast with a series of 107 consecutive cases.

Methods: Single-centre, retrospective, anatomoclinical study with application of the European guidelines adopting as pathological definition the presence of areas of micro-invasion not exceeding 1mm. Axillary lymph node dissection was systematically complete and was preceded by the search for the sentinel node in 10 patients using the isotope method.

Results: Lymph node invasion was revealed in 8 cases in the global population (7.5%). All the cases except one exhibited typical deleterious histological features: comedo architectural sub-type, high nuclear grade, and size of the lesion>3 cm. The lymph node invasion was of 18.5% in the sub-group of high-grade micro-invasive comedo-carcinomas measuring more than 3 cm.

Conclusion: Contrary to those exhibiting pure DCIS, DCIS-MI patients require surgical exploration of the armpit, the most appropriate modalities of which are currently debated: classical axillary lymph node dissection or search for the sentinel lymph node; the selective lymphadenectomy procedure is not yet a consensually validated technique.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Axilla
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / surgery
  • Female
  • Humans
  • Lymph Node Excision*
  • Lymphatic Metastasis / diagnosis*
  • Middle Aged
  • Neoplasm Invasiveness*
  • Practice Guidelines as Topic*
  • Prognosis
  • Retrospective Studies