Risk Prediction for Local Breast Cancer Recurrence Among Women with DCIS Treated in a Community Practice: A Nested,...

Area of Science:

• Oncology
• Surgical Oncology
• Biostatistics

Background:

• Local recurrence (LR) risk after breast-conserving therapy (BCT) for ductal carcinoma in situ (DCIS) is influenced by various factors.
• The predictive accuracy of combining these factors, especially in community practice, remains uncertain.

Purpose of the Study:

• To assess the validity of the Memorial Sloan-Kettering Cancer Center (MSKCC) DCIS nomogram in a population-based cohort.
• To evaluate the nomogram's ability to predict LR in patients with DCIS treated with BCT in community practices.

Main Methods:

• Review of patient slides with unilateral DCIS treated with BCT.
• Application of the MSKCC DCIS nomogram to predict and compare observed LR at 5 and 10 years.
• Use of regression methods to estimate LR risks.

Main Results:

• The MSKCC DCIS nomogram demonstrated good correlation (0.95) between predicted and observed 10-year LR.
• The nomogram showed reasonable discrimination (c-statistic of 0.68).
• Significant differences in 5-year LR risk were observed between nomogram-defined quartiles (4.8% vs. 33.1%).

Conclusions:

• The MSKCC DCIS nomogram is a valid tool for predicting 5- and 10-year LR in DCIS patients undergoing BCT in community settings.
• The nomogram serves as a valuable decision-making aid for clinicians and patients.