A population-based validation study of the DCIS Score predicting recurrence risk in individuals treated by breast-conserving surgery alone View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2015-07

AUTHORS

Eileen Rakovitch, Sharon Nofech-Mozes, Wedad Hanna, Frederick L. Baehner, Refik Saskin, Steven M. Butler, Alan Tuck, Sandip Sengupta, Leela Elavathil, Prashant A. Jani, Michel Bonin, Martin C. Chang, Susan J. Robertson, Elzbieta Slodkowska, Cindy Fong, Joseph M. Anderson, Farid Jamshidian, Dave P. Miller, Diana B. Cherbavaz, Steven Shak, Lawrence Paszat

ABSTRACT

Validated biomarkers are needed to improve risk assessment and treatment decision-making for women with ductal carcinoma in situ (DCIS) of the breast. The Oncotype DX DCIS Score (DS) was shown to predict the risk of local recurrence (LR) in individuals with low-risk DCIS treated by breast-conserving surgery (BCS) alone. Our objective was to confirm these results in a larger population-based cohort of individuals. We used an established population-based cohort of individuals diagnosed with DCIS treated with BCS alone from 1994 to 2003 with validation of treatment and outcomes. Central pathology assessment excluded cases with invasive cancer, DCIS < 2 mm or positive margins. Cox model was used to determine the relationship between independent covariates, the DS (hazard ratio (HR)/50 Cp units (U)) and LR. Tumor blocks were collected for 828 patients. Final evaluable population includes 718 cases, of whom 571 had negative margins. Median follow-up was 9.6 years. 100 cases developed LR following BCS alone (DCIS, N = 44; invasive, N = 57). In the primary pre-specified analysis, the DS was associated with any LR (DCIS or invasive) in ER+ patients (HR 2.26; P < 0.001) and in all patients regardless of ER status (HR 2.15; P < 0.001). DCIS Score provided independent information on LR risk beyond clinical and pathologic variables including size, age, grade, necrosis, multifocality, and subtype (adjusted HR 1.68; P = 0.02). DCIS was associated with invasive LR (HR 1.78; P = 0.04) and DCIS LR (HR 2.43; P = 0.005). The DCIS Score independently predicts and quantifies individualized recurrence risk in a population of patients with pure DCIS treated by BCS alone. More... »

PAGES

389-398

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10549-015-3464-6

DOI

http://dx.doi.org/10.1007/s10549-015-3464-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1017926754

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26119102


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