Patient selection: DCIS in core breast biopsy without any evidence of invasive disease
Parameters:
(1) diameter of the focus of DCIS in the excision specimen or mammography
(2) mammographic features
|
Parameter
|
Finding
|
Points
|
|
diameter of DCIS
|
< 5 cm
|
0
|
|
|
>= 5 cm
|
1
|
|
mammographic features
|
calcifications only
|
0
|
|
|
other features present
|
1
|
where:
• Other mammographic features include mass, architectural distortion, asymmetrical density, asymmetry and increased density (Table I, page 561).
number of risk factors for invasive carcinoma =
= SUM(points for both parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 2
• The higher the number of risk factors the greater the risk of invasive carcinoma.
• A woman at risk for invasive carcinoma should undergo a sentinel lymph node sampling. The authors recommended sentinel node biopsy if either finding is present.
NOTE: If the decision to perform a sentinel lymph node waits for the pathology report from the excision, then the patient needs to undergo 3 proceedures (core biopsy, excisional biopsy, sentinel node biopsy). If the size of the lesion is determined from mammography, then the woman could undergo the sentinel node biopsy at the same time as the excision.
