Abstract | PURPOSE: EXPERIMENTAL DESIGN: A biological signature that calculates an individualized Decision Score (DS) was developed and cross-validated in 526 DCIS patients treated with BCS ± RT. The relationship was assessed between DS and 10-year risk of invasive breast cancer (IBC) or any ipsilateral breast event (IBE), including IBC or DCIS. RT benefit was evaluated by risk group and as a function of DS. RESULTS: The DS was significantly associated with IBC and IBE risk, HR (per 5 units) of 4.2 and 3.1, respectively. For patients treated without RT, DS identified a Low Group with 10-year IBC risk of 4% (7% IBE) and an Elevated Risk Group with IBC risk of 15% (23% IBE). In analysis of DS and RT by group, the Elevated Risk Group received significant RT benefit, HR of 0.3 for IBC and IBE. In a clinicopathologically low-risk subset, DS reclassified 42% of patients into the Elevated Risk Group. In an interaction analysis of DS and RT, patients with elevated DS had significant RT benefit over baseline. CONCLUSIONS: The DS was prognostic for risk and predicted RT benefit for DCIS patients. DS identified a clinically meaningful low-risk group and a group with elevated 10-year risks that received substantial RT benefit over baseline.
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Authors | Troy Bremer, Pat W Whitworth, Rakesh Patel, Jess Savala, Todd Barry, Stephen Lyle, Glen Leesman, Steven P Linke, Karin Jirström, Wenjing Zhou, Rose-Marie Amini, Fredrik Wärnberg |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 24
Issue 23
Pg. 5895-5901
(12 01 2018)
ISSN: 1557-3265 [Electronic] United States |
PMID | 30054280
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | ©2018 American Association for Cancer Research. |
Chemical References |
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Topics |
- Adult
- Aged
- Biomarkers, Tumor
- Breast Neoplasms
(diagnosis, mortality, radiotherapy)
- Carcinoma, Intraductal, Noninfiltrating
(diagnosis, mortality, radiotherapy)
- Combined Modality Therapy
- Female
- Humans
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local
- Prognosis
- Proportional Hazards Models
- Treatment Outcome
- Tumor Burden
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