A Nomogram Using Imaging Features to Predict Ipsilateral Breast Tumor Recurrence After Breast-Conserving Surgery for...

Area of Science:

• Oncology
• Radiology
• Surgical Oncology

Background:

• Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer.
• Breast-conserving surgery (BCS) is a common treatment for DCIS.
• Predicting ipsilateral breast tumor recurrence (IBTR) after BCS is crucial for patient management.

Purpose of the Study:

• To develop a predictive nomogram for IBTR in women with DCIS treated with BCS.
• To integrate clinical-pathologic and imaging variables for enhanced prediction accuracy.
• To validate the nomogram's performance against existing models.

Main Methods:

• Retrospective study of women with DCIS treated with BCS (development and validation cohorts).
• Analysis of 12 clinical-pathologic and 6 imaging variables.
• Cox proportional hazard regression to identify predictive factors for IBTR.
• Nomogram construction and external validation using calibration plots and AUROC curves.

Main Results:

• The developed nomogram incorporated age, margin width, adjuvant radiation therapy, breast density, and calcification morphology.
• The nomogram demonstrated appropriate calibration in the validation cohort.
• The 10-year AUROC for the new nomogram was comparable to the MSKCC nomogram (0.73 vs. 0.66).

Conclusions:

• The developed nomogram provides individualized IBTR risk estimates for DCIS patients undergoing BCS.
• The nomogram's discriminative ability is comparable to the established MSKCC nomogram.
• This tool can aid in personalized treatment decisions and follow-up strategies for DCIS patients.