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A Biological Signature for Breast Ductal Carcinoma In Situ to Predict Radiotherapy Benefit and Assess Recurrence Risk
PreludeDx, 26051 Merit Circle Suite 102, Laguna Hills, CA 92653 USA.
Nashville Breast Ctr, Nashville, TN USA.
Good Samaritan Canc Ctr, Los Gatos, CA USA.
PreludeDx, 26051 Merit Circle Suite 102, Laguna Hills, CA 92653 USA.
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2018 (English)In: Clinical Cancer Research, ISSN 1078-0432, E-ISSN 1557-3265, Vol. 24, no 23, p. 5895-5901Article in journal (Refereed) Published
Abstract [en]

Purpose: Ductal carcinoma in situ (DCIS) patients and their physicians currently face challenging treatment decisions with limited information about the individual's subsequent breast cancer risk or treatment benefit. The DCI-SionRT biological signature developed in this study provides recurrence risk and predicts radiotherapy (RT) benefit for DCIS patients following breast-conserving surgery (BCS). 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.

Place, publisher, year, edition, pages
2018. Vol. 24, no 23, p. 5895-5901
National Category
Cancer and Oncology Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
URN: urn:nbn:se:uu:diva-372771DOI: 10.1158/1078-0432.CCR-18-0842ISI: 000452374700013PubMedID: 30054280OAI: oai:DiVA.org:uu-372771DiVA, id: diva2:1278260
Available from: 2019-01-14 Created: 2019-01-14 Last updated: 2019-03-29Bibliographically approved

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Zhou, WenjingAmini, Rose-MarieWärnberg, Fredrik

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