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The Clinical Utility of DCISionRT® on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery.
Shah, Chirag; Bremer, Troy; Cox, Charles; Whitworth, Pat; Patel, Rakesh; Patel, Anushka; Brown, Eric; Gold, Linsey; Rock, David; Riley, Lee; Kesslering, Christy; Brown, Sheree; Gabordi, Robert; Pellicane, James; Rabinovich, Rachel; Khan, Sadia; Templeton, Sandra; Majithia, Lonika; Willey, Shawna C; Wärnberg, Fredrik; Gerber, Naamit K; Shivers, Steve; Vicini, Frank A.
Afiliación
  • Shah C; Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Bremer T; PreludeDx, Laguna Hills, CA, USA.
  • Cox C; University of South Florida, Tampa, FL, USA.
  • Whitworth P; Nashville Breast Center, Nashville, TN, USA.
  • Patel R; Sutter Health, Castro Valley, CA, USA.
  • Patel A; Arizona Center for Cancer Care, Phoenix, AZ, USA.
  • Brown E; Comprehensive Breast Care, Michigan Healthcare Professionals, Troy, MI, USA.
  • Gold L; Comprehensive Breast Care, Michigan Healthcare Professionals, Troy, MI, USA.
  • Rock D; GenesisCare, Fort Myers, FL, USA.
  • Riley L; St. Luke's Hospital, Allentown, PA, USA.
  • Kesslering C; Radiation Oncology Department, Northwestern Medicine, Warrenville, IL, USA.
  • Brown S; Wellstar Radiation Oncology, Hiram, GA, USA.
  • Gabordi R; BayCare Medical Group, Tampa, FL, USA.
  • Pellicane J; Bon Secours, Richmond, VA, USA.
  • Rabinovich R; Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA.
  • Khan S; Hoag Breast Center, Irvine, CA, USA.
  • Templeton S; Department of Surgery, Houston Methodist, Sugar Land, TX, USA.
  • Majithia L; Radiation Oncology Associates, Fairfax, VA, USA.
  • Willey SC; Schar Cancer Institute, Inova, Fairfax, VA, USA.
  • Wärnberg F; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Gerber NK; Department of Radiation Oncology, Laura and Isaac Perlmutter Cancer Center, New York, NY, USA.
  • Shivers S; PreludeDx, Laguna Hills, CA, USA.
  • Vicini FA; GenesisCare, Michigan Healthcare Professionals, Farmington Hills, MI, USA. Frank.Vicini@21co.com.
Ann Surg Oncol ; 28(11): 5974-5984, 2021 Oct.
Article en En | MEDLINE | ID: mdl-33821346
BACKGROUND: The role of radiation therapy (RT) following breast-conserving surgery (BCS) in ductal carcinoma in situ (DCIS) remains controversial. Trials have not identified a low-risk cohort, based on clinicopathologic features, who do not benefit from RT. A biosignature (DCISionRT®) that evaluates recurrence risk has been developed and validated. We evaluated the impact of DCISionRT on clinicians' recommendations for adjuvant RT. METHODS: The PREDICT study is a prospective, multi-institutional, observational registry in which patients underwent DCISionRT testing. The primary endpoint was to identify the percentage of patients where testing led to a change in RT recommendations. RESULTS: Overall, 539 women were included in this study. Pre DCISionRT testing, RT was recommended to 69% of patients; however, post-testing, a change in the RT recommendation was made for 42% of patients compared with the pre-testing recommendation; the percentage of women who were recommended RT decreased by 20%. For women initially recommended not to receive an RT pre-test, 35% had their recommendation changed to add RT following testing, while post-test, 46% of patients had their recommendation changed to omit RT after an initial recommendation for RT. When considered in conjunction with other clinicopathologic factors, the elevated DCISionRT score risk group (DS > 3) had the strongest association with an RT recommendation (odds ratio 43.4) compared with age, grade, size, margin status, and other factors. CONCLUSIONS: DCISionRT provided information that significantly changed the recommendations to add or omit RT. Compared with traditional clinicopathologic features used to determine recommendations for or against RT, the factor most strongly associated with RT recommendations was the DCISionRT result, with other factors of importance being patient preference, tumor size, and grade.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Carcinoma Intraductal no Infiltrante Tipo de estudio: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Carcinoma Intraductal no Infiltrante Tipo de estudio: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos