ComManDS study: Completion Mastectomy for DCIS and SLNB

A Study of the Role of Sentinel Node Biopsy during Completion Mastectomy for Ductal Carcinoma in Situ.


The prevalence of lymph node metastasis in localized Ductal Carcinoma in Situ (DCIS) is quite low, hence patients undergoing breast conserving surgery (BCS) for DCIS do not have staging axillary procedure (Sentinel lymph node biopsy SLNB). However, guidelines recommend SLNB for patients having mastectomy as an initial procedure for DCIS. A subset of patients proceed to have a completion mastectomy after BCS for a DCIS due to close/ involved margins, with no guidance on whether to stage the axilla (SLNB) with it. The risks of invasive cancer in completion mastectomy specimen or axillary lymph node metastasis are considered to be very low. We hypothesize that majority of patients undergoing completion mastectomy for DCIS will not have an invasive cancer and therefore the risks of SLNB like limb oedema and sensory loss outweigh the benefits. Moreover,the risk factors associated with invasive cancer in the completion mastectomy specimen could be identified, and this will depend on the sample size and its incidence.


In patients who undergo completion mastectomy following breast conserving surgery for screen detected DCIS, look for:

  • the incidence of invasive carcinoma following completion mastectomy
  • the incidence of sentinel node metastases during completion mastectomy
  • risk factors associated with invasive cancer in the completion mastectomy specimen

Steering committee Meeting: TBA


Recruitment to start soon

Study Leads

Mirza Baig

Rajaram Burrah

Steering Committee

Hiba Fatayer

Talal Majeed

Emma Blower

Urvashi Singh

Shaneel Shah

Prof Cliona Kirwan


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