Axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast.

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Abstract
PURE DUCTAL carcinoma in situ (DCIS) of the breast was infrequently diagnosed in the past, when it accounted for only 1% to 5% of all breast cancers. It usually presented as a palpable lesion, Paget disease, or bloody nipple discharge. Pure DCIS showed a 15-fold increase during the past 10 years, because of the widespread use of mammography for the detection of clinically nonpalpable tumors; now, it accounts for 20% or more of mammographically detected carcinomas1-3 and 12% of all newly diagnosed breast cancers. Standard treatment of DCIS is wide resection, with or without postoperative radiotherapy. A total mastectomy can be required in cases of extensive intramammary spread. Axillary dissection is not routinely indicated because of the low prevalence of nodal metastases, which is expected to be less than 2%,4 and the significant morbidity associated with lymph node dissection.

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