Document Detail

Detection of occult invasion in cases of ductal carcinoma in situ of the breast along with sentinel node metastasis.
MedLine Citation:
PMID:  23281914     Owner:  NLM     Status:  Publisher    
By definition, ductal carcinoma in situ (DCIS)-preinvasive breast cancer-does not metastasise to the lymph nodes. However, since the introduction of molecular whole-node analysis using the one-step nucleic acid amplification (OSNA) assay for sentinel node (SN) biopsies, the number of patients with DCIS and SN metastasis has increased. The pathogenesis and clinical management of DCIS with SN metastasis remain controversial. In this case-control study, in order to elucidate the pathogenesis of SN metastasis in DCIS, we compared occult invasions between the SN-positive and SN-negative DCIS and investigated predictive factors of occult invasion. The subjects comprised 24 patients selected from 285 patients with a routine postoperative diagnosis of DCIS who had undergone SN biopsy using the OSNA whole-node assay between 2009 and 2011: 12 were SN-positive and 12 were SN-negative patients selected from the 273 SN-negative patients with similar characteristics (control group). All paraffin blocks of the primary tumor from each patient were step-sectioned with 500-μm intervals until the block was exhausted and were histopathologically examined. We analyzed 1,830 step-sectioned slides and found occult invasions were more frequent in the SN-positive group (7/12, 58.3%) than in the SN-negative group (3/12, 25.0%). All occult invasions were <5 mm. There was no correlation between occult invasion and SN tumor burden, non-SN metastasis, or patient characteristics. Our results suggest true metastasis from occult invasion may be a potent pathogenesis indicating nodal metastasis in postoperatively diagnosed DCIS. Patient follow-up is required to elucidate the prognostic impact of the nodal metastasis and occult invasion.
Tomo Osako; Takuji Iwase; Kiyomi Kimura; Rie Hor; Futoshi Akiyama
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-3
Journal Detail:
Title:  Cancer science     Volume:  -     ISSN:  1349-7006     ISO Abbreviation:  Cancer Sci.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101168776     Medline TA:  Cancer Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 Japanese Cancer Association.
Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan; Department of Pathology, the Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
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