Analyzing the Risk of Recurrence after Mastectomy for DCIS: A New Use for the USC/Van Nuys Prognostic Index.

00:19 EDT 2nd September 2014 | BioPortfolio

Summary of "Analyzing the Risk of Recurrence after Mastectomy for DCIS: A New Use for the USC/Van Nuys Prognostic Index."


BACKGROUND:
Patients with ductal carcinoma in situ (DCIS) who are treated with mastectomy seldom recur locally or with metastatic disease. When patients with DCIS recur with invasive cancer, they are upstaged and their lives are threatened. We questioned whether histopathologic data could be used to predict these infrequent events.
METHODS:
We reviewed a prospective database of 1,472 patients with pure DCIS. All patients were scored from 4 to 12 using the USC Van Nuys Prognostic Index, an algorithm based on DCIS size, nuclear grade, necrosis, margin width, and patient age. Probabilities of recurrence and death were calculated using the Kaplan-Meier method.
RESULTS:
A total of 496 patients with pure DCIS were treated with mastectomy. None received any form of postmastectomy adjuvant treatment. Average follow-up was 83 months. Eleven patients developed recurrences, all of whom scored 10-12 using the USC/VNPI. No patient who scored 4-9 recurred. All 11 patients who recurred had multifocal disease and comedo-type necrosis. The probability of disease recurrence after mastectomy for patients scoring 10-12 was 9.6% at 12 years, compared with 0% for those scoring 4-9. There was no difference in overall survival.
CONCLUSIONS:
There were no recurrences among mastectomy patients who scored 4-9 using the USC/VNPI. Patients scoring 10-12 were significantly more likely to develop recurrence after mastectomy. At risk were young patients with large, high-grade, and multifocal or multicentric tumors. For every 100 patients with USC/VNPI scores of 10-12, 10 patients will recur by 12 years and 2-3 will develop metastatic disease.

Affiliation

Department of Surgical Oncology, University of Southern California, Los Angeles, USA, leah.m.kelley@gmail.com.

Journal Details

This article was published in the following journal.

Name: Annals of surgical oncology
ISSN: 1534-4681
Pages:

Links

PubMed Articles [15479 Associated PubMed Articles listed on BioPortfolio]

A Comparison of Tumor Biology in Primary Ductal Carcinoma In Situ Recurring as Invasive Carcinoma versus a New In Situ.

Introduction. About half of all new ipsilateral events after a primary ductal carcinoma in situ (DCIS) are invasive carcinoma. We studied tumor markers in the primary DCIS in relation to type of event...

Perioperative Breast MRI Is Not Associated with Lower Locoregional Recurrence Rates in DCIS Patients Treated With or Without Radiation.

For women with ductal carcinoma in situ (DCIS) undergoing breast-conserving surgery (BCS), the benefit of magnetic resonance imaging (MRI) remains unknown. Here we examine the relationship of MRI and ...

Is a preoperative assessment of the early recurrence of pancreatic cancer possible after complete surgical resection?

The prognosis of pancreatic adenocarcinoma (PAC) is poor. The serum carbohydrate antigen 19-9 (CA 19-9) level has been identified as a prognostic indicator of recurrence and reduced overall survival. ...

Impact of Breast Reconstruction on the Decision to Undergo Contralateral Prophylactic Mastectomy.

In the last decade, there has been increasing use of contralateral prophylactic mastectomy (CPM) in patients with unilateral breast cancer and ductal carcinoma-in-situ (DCIS) undergoing mastectomy. Al...

Age at diagnosis predicts local recurrence in women treated with breast-conserving surgery and postoperative radiation therapy for ductal carcinoma in situ: a population-based outcomes analysis.

The main goal of treating ductal carcinoma in situ (dcis) is to prevent the development of invasive breast cancer. Most women are treated with breast-conserving surgery (bcs) and radiotherapy. Age at ...

Clinical Trials [2463 Associated Clinical Trials listed on BioPortfolio]

A Pilot Study to Evaluate Nipple-Areolar Complex (NAC) Sparing Mastectomy

Primary Objectives: - To prospectively evaluate the feasibility of nipple-areolar complex (NAC) sparing mastectomy as an alternative procedure to skin-sparing mastectomy for patie...

Registry of Mastectomy for Breast Cancer Risk Reduction

This is a registry for patients who have a risk-reduction mastectomy ("prophylactic mastectomy") due to being at high risk for developing breast cancer, followed by breast reconstruction. ...

Educational Interventions for Patients With DCIS

The purpose of this study is to determine whether adding an educational intervention, in the form of a decision board, which outlines the risks and benefits of treatment options for DCIS, ...

Radiation Doses and Fractionation Schedules in Non-Low Risk Ductal Carcinoma In Situ (DCIS) of the Breast

Aims: - To refine treatment selection for women with non-low risk DCIS to optimise disease control & minimize toxicity - Clinical: To evaluate outcomes after breast cons...

Nipple Sparing Mastectomy

The purpose of this study is to observe the cosmetic outcomes, patient satisfaction, and complications after skin sparing mastectomy with preservation of the nipple areolar complex. These...

Medical and Biotech [MESH] Definitions

Total mastectomy with axillary node dissection, but with preservation of the pectoral muscles.

Radical mastectomy with removal of the ipsilateral half of the sternum and a portion of ribs two through five with the underlying pleura and the internal mammary lymph nodes.

The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site.

Reduction of high-risk choices and adoption of low-risk quantity and frequency alternatives.

Search BioPortfolio: