Navigation Links
Prediction tool helps estimate local recurrence in patients with noninvasive breast cancer
Date:7/13/2010

NEW YORK, July 13, 2010 The decision regarding treatment following breast-conserving surgery for patients diagnosed with ductal carcinoma in-situ (DCIS) has long been an area of discussion and confusion for patients and physicians alike. While the mortality rates for DCIS remain low, the risk of local recurrence in the breast is high. Standard treatments following surgery include radiation therapy and hormone treatment. While both treatments have been proven to lower the risk of recurrence in the breast, neither has been shown to improve survival, and both carry potentially serious risks. In an attempt to help physicians and patients weigh the risks and benefits of the available options, researchers from Memorial Sloan-Kettering Cancer Center (MSKCC) are reporting in the Journal of Clinical Oncology on the development of a new prediction tool that calculates a patient's individualized risk for recurrence five and ten years after surgery.

"For the first time, using readily available information, a patient and her oncologist can estimate her individualized risk, and then use this tool to help in the decision-making process regarding treatment options," said Kimberly Van Zee, MD, an attending surgeon in the Breast Cancer Surgical Service at Memorial Sloan-Kettering Cancer Center and the study's lead author. "To date, there has been no other way to integrate all of the known risk factors for recurrence and come up with an individualized absolute risk estimate. This nomogram will be a valuable tool in weighing the pros and cons of various treatments."

Today, approximately one in five new breast cancer cases will be diagnosed as DCIS, making non-invasive breast cancer the fourth most commonly diagnosed malignancy in women. In 2009, more than 67,000 new cases of DCIS were diagnosed in the United States. Experts cite increased use of screening methods such as mammography as the reason for the rise in case numbers.

In DCIS, cancer cells are confined to an area within the ducts of the breast and have not invaded surrounding breast tissue outside the ducts. Because DCIS is an early-stage breast cancer, survival following treatment for DCIS is about 98 percent. Paradoxically, however, the ten-year local breast recurrence rate is about 15 percent which is higher than the ten-year recurrence rate for women who have received breast-conserving treatment for invasive cancer. (Local recurrence is about 3 to 7 percent in women with invasive cancer who have received systemic therapy.)

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.


'/>"/>

Contact: Courtney DeNicola
denicolc@mskcc.org
212-639-3573
Memorial Sloan-Kettering Cancer Center
Source:Eurekalert

Related medicine news :

1. New clinical prediction index to help patients considering kidney transplant
2. Calcium Scan Improves Heart Risk Prediction
3. Logica Partners With Consensus Point To Predict The Future Uses Prediction Market Technology To Provide Insight And Trends
4. UNT Health Science Centers Roby Helps Identify Bodies of Chiles Patio 29
5. MarquisNet Co-Location Agreement with MessageBroadcast Helps Message Delivery Provider Expand World-Class Network
6. Launch of On Time Air Filters: Home Air Filter Delivery Service Helps Homeowners Replace All-Important Home HVAC Filters On Time
7. New intervention helps Latino parents of asthmatic children quit smoking
8. Hair Loss: Must See Photos - Scalpure Hair Mask Helps Hair Loss
9. Exercise helps protect brain of multiple sclerosis patients
10. Device Helps Kids With Single-Sided Deafness
11. CustomerCentric Selling Helps BCC Software Dramatically Boost Sales Performance and Produce Record Results
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... , ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library on ... Observer , brings up a new, often overlooked aspect of head lice: the parasite’s ability ... fumigation is not a common occurrence, but a necessary one in the event that lice ...
(Date:6/25/2016)... Oklahoma City, Oklahoma (PRWEB) , ... June 25, ... ... to helping both athletes and non-athletes recover from injury. Recently, he has implemented ... for the Oklahoma City area —Johnson is one of the first doctors to ...
(Date:6/24/2016)... Marne, Michigan (PRWEB) , ... June 24, 2016 , ... ... To deal with these feelings, many turn to unhealthy avenues, such as drug or ... Center of Marne, Michigan, has released tools for healthy coping following a traumatic event. ...
(Date:6/24/2016)... ... 24, 2016 , ... Global law firm Greenberg Traurig, P.A. announced that 20 ... by their peers for this recognition are considered among the top 2 percent of ... honors as members of this year’s Legal Elite Hall of Fame: Miami Shareholders ...
(Date:6/24/2016)... ... June 24, 2016 , ... People across the U.S. are ... Code Talker Award, an essay contest in which patients and their families pay tribute ... presented at the 2016 National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 24, 2016  Consumers have taken a more ... placed more emphasis on patient outcomes. ... in the pharmaceutical industry have evolved beyond just ... companies are focusing on becoming more patient-oriented across ... and services that improve health. ...
(Date:6/24/2016)... 24, 2016   Bay Area Lyme Foundation ... Dean Center for Tick Borne Illness , Harvard ... MIT Hacking Medicine, University of California, Berkeley, and ... the five finalists of Lyme Innovation , ... than 100 scientists, clinicians, researchers, entrepreneurs, and investors ...
(Date:6/24/2016)... The Academy of Managed Care Pharmacy (AMCP) ... would allow biopharmaceutical companies to more easily share health ... and coverage decisions, a move that addresses the growing ... The recommendations address restrictions in the sharing of ... label, a prohibition that hinders decision makers from accessing ...
Breaking Medicine Technology: