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Axillary Node Dissection in DCIS Offers Little Prognostic Information

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“If it’s pure DCIS, don’t do the sentinel biopsy, because you have less than a 1% chance of it being positive and greater risks of developing other complications.”…

I was stunned when I first found out that lymph nodes were being sampled for those with many forms of DCIS.  The axillary node dissection which was used in the earlier years of this study has a high potential for causing lymphedema.  The sentinel node biopsy that is often currently performed has a lower chance of causing lymphedema, but it is not a negligible chance.  It is well worth the risk if you have invasive breast cancer, but, in my opinion, would almost never be worth the risk in pure DCIS.

Another recent article “Ductal carcinoma in situ of the breast: a systematic review of incidence, treatment, and outcomes” which is included on People Beating Cancer reaches a slightly different conclusion.

“A new study presented at the American Society of Breast Surgeons (ASBrS) 11th Annual Meeting indicates that 2 commonly used procedures — axillary node dissection and sentinel lymph node biopsy — might pose more harm than good to patients with pure ductal carcinoma in situ (DCIS).

Amy Bremner, MD, a surgeon at Hoag Memorial Hospital Presbyterian in Newport Beach, California, told Medscape Oncology that her findings indicate that not only do these procedures and their subsequent findings not affect survival “in any way,” the procedure itself carries some morbidity — albeit low. “So unless there are circumstances that have an invasive component,” she said, “we would say do not do it.”

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Mary Miller-BC Profile in Courage

Axillary Node Dissection in DCIS Offers Little Prognostic Information

“A new study presented here at the American Society of Breast Surgeons (ASBrS) 11th Annual Meeting indicates that 2 commonly used procedures — axillary node dissection and sentinel lymph node biopsy — might pose more harm than good to patients with pure ductal carcinoma in situ (DCIS)…

Other adverse effects that can accompany sentinel node biopsy are arm pain and inflammation. “What you want to do is minimize the risk and minimize the morbidity,” said Dr. Attai. “If it’s pure DCIS, don’t do the sentinel biopsy, because you have less than a 1% chance of it being positive and greater risks of developing other complications.”…

 

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