when sentinel node biopsy is recommended in case of in situ ductal carcinoma of the breast

What is it about?

A broad range of diseases is grouped under the group DCIS, ranging from low-grade indolent to high-grade aggressive tumours. We still do not know which DCIS lesions will progress or not with the result that every DCIS is now treated similarly to the invasive ones. Particularly with regard to the axillary staging, whose role and management is under debate, the risk is an overtreatment, not immune by side effects. With the fear of an underestimation of the invasive cancer in the final pathology of DCIS (reported in as many as 10–40% of cases), the result is a trend in performing the SLNB much more frequently than necessary. At the present time, based on currently available data, we can affirm that SLNB is recommended in case of DCIS for patients undergoing mastectomy. In case of breast-conserving surgery, SLNB should be considered not as an upfront strategy but on a case-by-case basis, only for DCIS at high risk of association to invasive cancer or for large tumours, avoiding the axillary evaluation in all the other low-risk cases.

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