Resumo

ACOSTA F, Víctor et al. Carcinoma ductal in situ. experiencia en el centro clínico de estereotaxia ceclines. Rev. venez. oncol. [online]. 2006, vol.18, n.1, pp.2-8. ISSN 0798-0582.

OBJECTIVE: Analyze feasibility of pre-operative percutaneous diagnosis and indications of sentinel node biop-sy in ductal carcinoma in situ. METHODS: Fifty cases of ductal carcinoma in situ treated from March 1997 through November 2004 were analyzed. We define pureductal carcinoma in situ as those lesions without evidence of micro-invasion; ductal carcinoma in situ with micro-invasion (ductal carcinoma in situ-mic) are those with infiltration equal or less than 2mm or 3 clusters of micro-invasion equal or less than 1mm. All had pre-operative biopsies: 41 (82 %) percutaneous and 9 (18 %) excisional. Ductal carcinoma in situ was classified according to histological patterns as solid, cribiform, micro-papillary and mixed. In 22 patients (44 %) biopsy of the sentinel node was performed (SG): 11 (50 %) cases were ductal carcinoma in situ and 11 (50 %) ductal carcinoma in situ-mic. RESULTS: Regarding percutaneous biopsies, 70.75 % were pure ductal carcinoma in situ and 29.26 % were ductal carcinoma in situ-mic. 96 % were treated with surgery with or without radiotherapy and 4 % received radiotherapy as the only treatment. Of those treated with surgery, 69.23 % were pure ductal carcinoma in situ and 30.76 % were ductal carcinoma in situ-mic. In 5 cases (12.82 %), there was a misdiagnosis of pure ductal carcinoma in situ in the biopsy, and the study of the surgical specimen revealed microinvasion. In 95.45 % of the cases the SG was identified and in 95.23 % of the cases, it was negative. There was no evidence of positive SG in cases of pure ductal carcinoma in situ. CONCLUSIONS: We recommend pre-operative percutaneous tissue diagnosis in ductal carcinoma in situ. In ductal carcinoma in situ-mic, SG biopsy should be performed.

Palavras-chave : Cancer; breast; carcinoma in situ; diagnosis; sentinel node; treatment; surgery; radiotherapy.