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

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-conserv...

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Autores principales: Rakovitch, Eileen, Nofech-Mozes, Sharon, Hanna, Wedad, Baehner, Frederick L., Saskin, Refik, Butler, Steven M., Tuck, Alan, Sengupta, Sandip, Elavathil, Leela, Jani, Prashant A., Bonin, Michel, Chang, Martin C., Robertson, Susan J., Slodkowska, Elzbieta, Fong, Cindy, Anderson, Joseph M., Jamshidian, Farid, Miller, Dave P., Cherbavaz, Diana B., Shak, Steven, Paszat, Lawrence
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4491104/
https://www.ncbi.nlm.nih.gov/pubmed/26119102
http://dx.doi.org/10.1007/s10549-015-3464-6
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author Rakovitch, Eileen
Nofech-Mozes, Sharon
Hanna, Wedad
Baehner, Frederick L.
Saskin, Refik
Butler, Steven M.
Tuck, Alan
Sengupta, Sandip
Elavathil, Leela
Jani, Prashant A.
Bonin, Michel
Chang, Martin C.
Robertson, Susan J.
Slodkowska, Elzbieta
Fong, Cindy
Anderson, Joseph M.
Jamshidian, Farid
Miller, Dave P.
Cherbavaz, Diana B.
Shak, Steven
Paszat, Lawrence
author_facet Rakovitch, Eileen
Nofech-Mozes, Sharon
Hanna, Wedad
Baehner, Frederick L.
Saskin, Refik
Butler, Steven M.
Tuck, Alan
Sengupta, Sandip
Elavathil, Leela
Jani, Prashant A.
Bonin, Michel
Chang, Martin C.
Robertson, Susan J.
Slodkowska, Elzbieta
Fong, Cindy
Anderson, Joseph M.
Jamshidian, Farid
Miller, Dave P.
Cherbavaz, Diana B.
Shak, Steven
Paszat, Lawrence
author_sort Rakovitch, Eileen
collection PubMed
description 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 C(p) 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10549-015-3464-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-44911042015-07-08 A population-based validation study of the DCIS Score predicting recurrence risk in individuals treated by breast-conserving surgery alone Rakovitch, Eileen Nofech-Mozes, Sharon Hanna, Wedad Baehner, Frederick L. Saskin, Refik Butler, Steven M. Tuck, Alan Sengupta, Sandip Elavathil, Leela Jani, Prashant A. Bonin, Michel Chang, Martin C. Robertson, Susan J. Slodkowska, Elzbieta Fong, Cindy Anderson, Joseph M. Jamshidian, Farid Miller, Dave P. Cherbavaz, Diana B. Shak, Steven Paszat, Lawrence Breast Cancer Res Treat Clinical Trial 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 C(p) 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10549-015-3464-6) contains supplementary material, which is available to authorized users. Springer US 2015-06-29 2015 /pmc/articles/PMC4491104/ /pubmed/26119102 http://dx.doi.org/10.1007/s10549-015-3464-6 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Clinical Trial
Rakovitch, Eileen
Nofech-Mozes, Sharon
Hanna, Wedad
Baehner, Frederick L.
Saskin, Refik
Butler, Steven M.
Tuck, Alan
Sengupta, Sandip
Elavathil, Leela
Jani, Prashant A.
Bonin, Michel
Chang, Martin C.
Robertson, Susan J.
Slodkowska, Elzbieta
Fong, Cindy
Anderson, Joseph M.
Jamshidian, Farid
Miller, Dave P.
Cherbavaz, Diana B.
Shak, Steven
Paszat, Lawrence
A population-based validation study of the DCIS Score predicting recurrence risk in individuals treated by breast-conserving surgery alone
title A population-based validation study of the DCIS Score predicting recurrence risk in individuals treated by breast-conserving surgery alone
title_full A population-based validation study of the DCIS Score predicting recurrence risk in individuals treated by breast-conserving surgery alone
title_fullStr A population-based validation study of the DCIS Score predicting recurrence risk in individuals treated by breast-conserving surgery alone
title_full_unstemmed A population-based validation study of the DCIS Score predicting recurrence risk in individuals treated by breast-conserving surgery alone
title_short A population-based validation study of the DCIS Score predicting recurrence risk in individuals treated by breast-conserving surgery alone
title_sort population-based validation study of the dcis score predicting recurrence risk in individuals treated by breast-conserving surgery alone
topic Clinical Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4491104/
https://www.ncbi.nlm.nih.gov/pubmed/26119102
http://dx.doi.org/10.1007/s10549-015-3464-6
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