Genomic Assays to Assess Local Recurrence Risk and Predict Radiation Therapy Benefit in Patients With Ductal Carcinoma In Situ

2019 ◽  
Vol 103 (5) ◽  
pp. 1021-1025 ◽  
Author(s):  
Mylin A. Torres
Keyword(s):  
Radiation Therapy ◽  
Local Recurrence ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Recurrence Risk ◽  
Genomic Assays

Invasive local recurrence increased after radiation therapy for ductal carcinoma in situ

2008 ◽  
Vol 196 (4) ◽  
pp. 552-555 ◽  
Author(s):  
Lisa E. Guerra ◽  
Robina M. Smith ◽  
Anna Kaminski ◽  
Michael D. Lagios ◽  
Melvin J. Silverstein
Keyword(s):  
Radiation Therapy ◽  
Local Recurrence ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma

Assessing the Benefit of Radiation Therapy After Breast-Conserving Surgery for Ductal Carcinoma-In-Situ

2005 ◽  
Vol 23 (22) ◽  
pp. 5171-5177 ◽  
Author(s):  
James A. Hayman ◽  
Mohammed U. Kabeto ◽  
Matthew J. Schipper ◽  
Jonathan E. Bennett ◽  
Frank A. Vicini ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Local Recurrence ◽  
Ductal Carcinoma In Situ ◽  
Initial Treatment ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Health States ◽  
Similar Reduction

Purpose To assess women's preferences regarding the trade-off between the risks and benefits of treatment with radiation therapy (RT) after breast-conserving surgery (BCS) for ductal carcinoma-in-situ (DCIS). Patients and Methods Utilities were obtained from 120 patients and 210 nonpatients for eight relevant health states using standard gambles. Results Differences in utilities obtained from patient and nonpatient participants between health states were relatively similar. Reduction in the likelihood of local recurrence associated with RT did not result in higher utilities. Utilities for noninvasive recurrence were only lower after initial treatment with RT. Patient and nonpatient participants had the lowest utilities for invasive local recurrence, regardless of initial treatment or manner of salvage therapy. When comparing patient and nonpatient utilities directly, patients had higher utility for being without recurrence after initial RT and lower utility for invasive recurrence salvaged by mastectomy after initial BCS alone. None of the clinical or sociodemographic factors examined explained more than 5% of the variability in the patients' or nonpatients' utilities or their differences. Conclusion The principal benefit associated with adding RT to BCS for DCIS seems to be its ability to reduce invasive recurrences.

scholarly journals A Multigene Expression Assay to Predict Local Recurrence Risk for Ductal Carcinoma In Situ of the Breast

2013 ◽  
Vol 105 (10) ◽  
pp. 701-710 ◽  
Author(s):  
L. J. Solin ◽  
R. Gray ◽  
F. L. Baehner ◽  
S. M. Butler ◽  
L. L. Hughes ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Recurrence Risk ◽  
Multigene Expression

Long-term rates of breast cancer in a population of women with ductal carcinoma in situ treated by breast-conserving surgery.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1123-1123
Author(s):  
Eileen Rakovitch ◽  
Sharon Nofech-Mozes ◽  
Steven Narod ◽  
Wedad Hanna ◽  
Refik Saskin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Local Recurrence ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Breast Preservation

1123 Background: Ductal Carcinoma in Situ (DCIS) is a non-invasive form of breast cancer which is often treated by breast-conserving surgery. The addition of radiotherapy to surgery has been shown to reduce the risk of local recurrence (LR), but use of radiotherapy varies. It is not known to what extent women with DCIS are at risk for recurrent cancer due to the omission of radiation therapy. We studied a large provincial cohort of women with DCIS who were treated with breast-conserving surgery for factors which predict local recurrence and estimate the impact of radiotherapy on local recurrence and long-term rates of breast preservation. Methods: All women diagnosed with DCIS in Ontario from 1994 to 2003 were identified. Treatments and outcomes were identified through administrative databases and validated by chart review. Women treated with breast-conserving surgery, alone or with radiotherapy, were included. Survival analyses were used to study local recurrence (DCIS or invasive) in relation to patient characteristics, tumour characteristics and treatment. Results: The cohort included 3975 women who were treated with breast-conserving therapy; of these, 1949 (49%) received radiation. At 10 years median follow-up, 736 developed LR(19%). LR developed in 259 of 1949 women who received radiotherapy (13%) and in 477 of 2026 women who did not (24%;p<0.001). The differences were significant for both invasive LR (7% vs. 14%; p<0.001) and DCIS recurrence (6% vs.9%; p<0.001). The 10-year cumulative rate of mastectomy was 13% for women who received radiotherapy compared to 17% for those who did not (p<0.01).We estimate that 29% (N=214) of all local recurrences diagnosed in Ontario in women treated for DCIS between 1994 and 2003 would be prevented if all patients received radiotherapy. Conclusions: The omission of radiation therapy after breast-conserving surgery in women with DCIS resulted in a substantial number of local recurrences that might have been avoided and lower rates of breast preservation. Improvements in guidelines that facilitate the selection of women in whom radiotherapy can be avoided are needed.

Effect of Margin Status on Local Recurrence After Breast Conservation and Radiation Therapy for Ductal Carcinoma In Situ

2009 ◽  
Vol 27 (10) ◽  
pp. 1615-1620 ◽  
Author(s):  
Clive Dunne ◽  
John P. Burke ◽  
Monica Morrow ◽  
Malcolm R. Kell
Keyword(s):  
Radiation Therapy ◽  
Local Recurrence ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conservation ◽  
Surgical Margin ◽  
Surgical Margins ◽  
Significant Difference

Purpose There is no consensus on what constitutes an adequate surgical margin in patients receiving breast-conserving surgery (BCS) and postoperative radiation therapy (RT) for ductal carcinoma in situ (DCIS). Inadequate margins may result in high local recurrence, and excessively large resections may lead to poor cosmetic outcome without oncologic benefit. Methods A comprehensive search for published trials that examined outcomes after adjuvant RT after BCS for DCIS was performed using MEDLINE and cross referencing available data. Reviews of each study were conducted, and data were extracted. Primary outcome was ipsilateral breast tumor recurrence (IBTR) related to surgical margins. Results A total of 4,660 patients were identified from trials examining BCS and RT for DCIS. Patients with negative margins were significantly less likely to experience recurrence than patients with positive margins after RT (odds ratio [OR] = 0.36; 95% CI, 0.27 to 0.47). A negative margin significantly reduced the risk of IBTR when compared with a close (OR = 0.59; 95% CI, 0.42 to 0.83) or unknown margin (OR = 0.56; 95% CI, 0.36 to 0.87). When specific margin thresholds were examined, a 2-mm margin was superior to a margin less than 2 mm (OR = 0.53; 95% CI, 0.26 to 0.96); however, we saw no significant difference in the rate of IBTR with margins between 2 mm and more than 5 mm (OR = 1.51; 95% CI, 0.51 to 5.0; P > .05). Conclusion Surgical margins negative for DCIS should be obtained after BCS for DCIS. A margin threshold of 2 mm seems to be as good as a larger margin when BCS for DCIS is combined with RT.

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