Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Prediction tool helps estimate local recurrence in patients with noninvasive breast cancer

14.07.2010
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.

Memorial Sloan-Kettering Cancer Center is the world's oldest and largest private institution devoted to prevention, patient care, research, and education in cancer. Our scientists and clinicians generate innovative approaches to better understand, diagnose, and treat cancer. Our specialists are leaders in biomedical research and in translating the latest research to advance the standard of cancer care worldwide. For more information, go to www.mskcc.org.

Courtney DeNicola | EurekAlert!
Further information:
http://www.mskcc.org

More articles from Health and Medicine:

nachricht Second cause of hidden hearing loss identified
20.02.2017 | Michigan Medicine - University of Michigan

nachricht Prospect for more effective treatment of nerve pain
20.02.2017 | Universität Zürich

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Impacts of mass coral die-off on Indian Ocean reefs revealed

21.02.2017 | Earth Sciences

Novel breast tomosynthesis technique reduces screening recall rate

21.02.2017 | Medical Engineering

Use your Voice – and Smart Homes will “LISTEN”

21.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>