The Clinical Significance Of Sentinel Lymph Node Biopsy In Breast Ductal Carcinoma In Situ: The Meta-analysis

Background: For ductal carcinoma in situ(DCIS) of the patient is necessary to sentinel lymph node biopsy(SLNB) is still controversial, theoretically due to ductal carcinoma in situ lesions in patients with invasive carcinoma component does not exist, there should be no axillary lymph node metastasis, and therefore sentinel lymph node biopsy may be a transitional treatment, but patients with DCIS cases of axillary lymph node metastases in clinical practice still encounter. Currently both supporters and opponents of view comes from a number of small studies, this document uses Meta-analysis was to compare the past on "sentinel lymph node biopsy in ductal carcinoma in situ" positive rate literature, influencing factors, clinical characteristics and other indicators, preliminary study for patients with DCIS clinical significance of sentinel lymph node biopsy.Materials and methods: In pubmed, VIP, CNKI, Wanfang Database systematic search of published studies from 2005-2015 DCIS sentinel lymph node biopsy in the literature, there are number of CIS eligibility criteria required sentinel lymph node biopsy and positive catheter and there are certain it is necessary to analyze whether sentinel lymph node biopsy. Documents retrieved using random effects models were combined, a total of 17, a total of 3036 cases of DCIS patients, and integrate the included studies have provided data related to cite studies Preoperative and postoperative diagnosis of ductal carcinoma in situ of the sentinel lymph node The positive rate and analysis of relevant risk factors in patients with ductal carcinoma in situ to analyze whether it is necessary to sentinel lymph node biopsy.Results: Which has nine research, while providing the appropriate number and the number of cases of positive sentinel lymph node biopsy in the preoperative and postoperative diagnosis of DCIS, and these nine research results are as follows: preoperative diagnosis of DCIS in the sentinel lymph node metastasis rate of 6.6 percent, after a diagnosis of DCIS incidence of sentinel lymph node metastasis 2.1%, between two significant differences, the relative risk(RR) was 3.17(95% CI 2.10,4.79), 17 个 surgery before the diagnosis of DCIS of sentinel lymph node metastasis was 6.3%, 18 after diagnosis of DCIS sentinel lymph node metastasis rate was 3.9%. Low level histological grade DCIS sentinel lymph node metastasis was 2.9% in the level of 5.0%, the high-level of 6.1%, RR, respectively(0.85 95% CI 0.52-1.40),(0.68 95% CI 0.42-1.09). The DCIS tumor ≤2cm sentinel lymph node metastasis rate was 1.7%, tumor> 2cm was 10.0%,(RR is 0.17 95% CI 0.09-0.33). DCIS aged ≤50 years of sentinel lymph node metastasis rate was 7.1 percent, aged> 50 years was 5.9%,(RR is 1.19 95% CI 0.82-1.71)。. DCIS Her-2 positive sentinel lymph node metastasis rate was 5.8%, Her-2 negative for 5.7,(RR is 1.02 95% CI 0.63-1.73).conclusion: The incidence of preoperative diagnosis of DCIS of sentinel lymph node metastasis was significantly higher than the incidence of DCIS diagnosed after sentinel lymph node metastasis in patients with preoperative diagnosis of DCIS is necessary to sentinel lymph node biopsy, we recommend the following DCIS patients sentinel lymph node biopsy : the larger mass, high histological grade, Her-2 overexpression, scheduled for mastectomy because of lost opportunities for secondary surgery, should sentinel node biopsy.