Loyola primary care physicians honored with Blue Ribbon rating from Blue Cross and Blue Shield

April 02, 2016

Large, randomized clinical trials have shown that radiation after breast-conserving surgery decreases local breast recurrence by about half in patients with DCIS. However, radiation does not result in better survival and carries rare but serious potential risks. Therefore, most radiation oncologists do not recommend radiation to all women with DCIS - rather, they attempt to identify those at lowest risk for recurrence and spare them radiation.

According to Dr. VanZee, until now, there has been no prediction tool to help doctors estimate the risk of recurrence and thus help identify which patients would benefit most from radiation therapy. As such, there is a need to generate an individualized estimate for the risk of recurrence when weighing the risks and benefits of said treatments. For example, in a woman at very high risk of recurrence, the added benefit of radiation and/or hormone treatments would be relatively large as compared to a woman at very low risk of recurrence.

In this study, researchers collected clinical and pathological data from 1,681 women who had breast-conserving surgery from 1991 to 2006 at MSKCC. The nomogram was built using ten variables, including the patient's age, family history, clinical presentation, margin status, and histopathological features such as nuclear grade and presence of necrosis - all commonly available factors.

"Given that nomograms have been repeatedly shown to be more accurate at risk estimation than expert opinion, it is very helpful to have mathematical models to integrate available information and improve the decision-making process for our patients," said Dr. Van Zee.

Source: Memorial Sloan-Kettering Cancer Center