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Richard J. Bleicher, MD; Armando E. Giuliano, MD
Santa Monica, Calif

Arch Surg. 2003;138:489.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

THE CONTROVERSY surrounding sentinel node biopsy for ductal carcinoma in situ (DCIS) is not new. The study by Intra et al¹ in the March issue of the ARCHIVES supports avoiding routine sentinel node biopsy for DCIS because of the low risk of nodal metastases.

By definition, DCIS cannot spread; it is not an invasive malignancy. Any evidence of breast epithelium in a lymph node from a patient with this disease represents either an inaccurate diagnosis or perhaps displacement of epithelial cells by tumor manipulation, such as a preoperative needle biopsy. If the cells are not displaced epithelium, but rather metastatic breast cancer, then the diagnosis of DCIS is not possible. Most likely, a sampling error has occurred, resulting in underdiagnosis. This is understandable because the pathologist can, in practice, only examine a small portion of the DCIS during routine histopathologic assessment. Although . . . [Full Text of this Article]

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