Comparison of Local Recurrence Risk Estimates After Breast-Conserving Surgery for DCIS: DCIS Nomogram Versus Refined Oncotype DX Breast DCIS Score
Background A ductal carcinoma in situ (DCIS) Nomogram integrating 10 clinicopathologic/treatment factors and a Refined DCIS Score (RDS) that incorporates a genomic assay and three clinicopathologic factors (Oncotype DX DCIS Score) are available to estimate DCIS 10-year local recurrence risk (LRR). T...
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| Veröffentlicht in: | Annals of surgical oncology 2019-10, Vol.26 (10), p.3282-3288 |
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| creator | Van Zee, Kimberly J. Zabor, Emily C. Di Donato, Rosemarie Harmon, Bryan Fox, Jana Morrow, Monica Cody, Hiram S. Fineberg, Susan A. |
| description | Background
A ductal carcinoma in situ (DCIS) Nomogram integrating 10 clinicopathologic/treatment factors and a Refined DCIS Score (RDS) that incorporates a genomic assay and three clinicopathologic factors (Oncotype DX DCIS Score) are available to estimate DCIS 10-year local recurrence risk (LRR). This study compared these estimates.
Methods
Patients 50 years of age or older with DCIS size 2.5 cm or smaller and a genomic assay available were identified. An RDS within 1–2% of the range of Nomogram LRR estimates obtained by assuming use and non-use of endocrine therapy (Nomogram ± ET) was defined as concordant. Assuming a 10-year risk threshold of 10% for recommending radiation, Nomogram ± ET and RDS estimates were compared, and threshold concordance was determined.
Results
For 54 (92%) of 59 patients, the RDS and Nomogram ± ET LRR estimates were concordant. For the remaining 5 (8%) of the 59 patients, the RDS LRR estimates were lower than the Nomogram + ET estimates, with an absolute difference of 3–8%, and thus were discordant. For these five patients, the RDS estimates of 10-year LRR were lower than 10% (range 5–8%) and the Nomogram + ET estimates were 10% or higher (range 11–14%). These five patients with both discordant and threshold-discordant estimates all had close margins (≤ 2 mm).
Conclusions
Among 92% of women 50 years of age or older with DCIS size 2.5 cm or smaller, free-of-charge online Nomogram 10-year LRR estimates were concordant with those obtained using the commercially available RDS (> $4600). Among the 8% with discordant risk estimates, the RDS appeared to underestimate the LRR and may lead to inappropriate omission of radiotherapy. Unless other data show a clinically significant advantage of the RDS (Oncotype DX DCIS Score), the study data suggest that for women 50 years of age or older with DCIS size 2.5 cm or smaller, its use is not warranted. |
| doi_str_mv | 10.1245/s10434-019-07537-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22927591</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2263017148</sourcerecordid><originalsourceid>FETCH-LOGICAL-c447t-4d33f003d6a71699b883e3caf94ea83b1c1746ad2c3ec7059d74ebd161bf964c3</originalsourceid><addsrcrecordid>eNp9kcFuFSEUhonR2Fp9AReGxPUoDAwM7uq0tk1ubNKrxh1hmMN1ageuwJjMa_jEYudqd26AwHd-zvl_hF5S8obWvHmbKOGMV4SqisiGyWp5hI5pU664aOnjciairVQtmiP0LKVbQqhkpHmKjhhlvGaSHaNfXZj2Jo4peBwc3gRr7vAN2DlG8BbwzZi-4_OUx8lkSPjUZYj4fQSTctUFnyD-HP0Ob-e4g7hgFyI-66627-5X_DFMYRfNhL9ATHMqwm70MOBrb0Ne9oDPvh7EVn5rQ4Tn6IkzdwleHPYT9PnD-afustpcX1x1p5vKci5zxQfGHCFsEEZSoVTftgyYNU5xMC3rqaWSCzPUloGVpFGD5NAPVNDeKcEtO0GvV91QxtPJjhnsNxu8B5t1XataNoo-UPsYfsyQsr4Nc_SlscIIViylvC1UvVI2hpQiOL2PxbK4aEr0n7D0GpYuYen7sPRSil4dpOd-guFfyd90CsBWIJUnXwx--Ps_sr8BrvOfew</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2263017148</pqid></control><display><type>article</type><title>Comparison of Local Recurrence Risk Estimates After Breast-Conserving Surgery for DCIS: DCIS Nomogram Versus Refined Oncotype DX Breast DCIS Score</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Van Zee, Kimberly J. ; Zabor, Emily C. ; Di Donato, Rosemarie ; Harmon, Bryan ; Fox, Jana ; Morrow, Monica ; Cody, Hiram S. ; Fineberg, Susan A.</creator><creatorcontrib>Van Zee, Kimberly J. ; Zabor, Emily C. ; Di Donato, Rosemarie ; Harmon, Bryan ; Fox, Jana ; Morrow, Monica ; Cody, Hiram S. ; Fineberg, Susan A.</creatorcontrib><description>Background
A ductal carcinoma in situ (DCIS) Nomogram integrating 10 clinicopathologic/treatment factors and a Refined DCIS Score (RDS) that incorporates a genomic assay and three clinicopathologic factors (Oncotype DX DCIS Score) are available to estimate DCIS 10-year local recurrence risk (LRR). This study compared these estimates.
Methods
Patients 50 years of age or older with DCIS size 2.5 cm or smaller and a genomic assay available were identified. An RDS within 1–2% of the range of Nomogram LRR estimates obtained by assuming use and non-use of endocrine therapy (Nomogram ± ET) was defined as concordant. Assuming a 10-year risk threshold of 10% for recommending radiation, Nomogram ± ET and RDS estimates were compared, and threshold concordance was determined.
Results
For 54 (92%) of 59 patients, the RDS and Nomogram ± ET LRR estimates were concordant. For the remaining 5 (8%) of the 59 patients, the RDS LRR estimates were lower than the Nomogram + ET estimates, with an absolute difference of 3–8%, and thus were discordant. For these five patients, the RDS estimates of 10-year LRR were lower than 10% (range 5–8%) and the Nomogram + ET estimates were 10% or higher (range 11–14%). These five patients with both discordant and threshold-discordant estimates all had close margins (≤ 2 mm).
Conclusions
Among 92% of women 50 years of age or older with DCIS size 2.5 cm or smaller, free-of-charge online Nomogram 10-year LRR estimates were concordant with those obtained using the commercially available RDS (> $4600). Among the 8% with discordant risk estimates, the RDS appeared to underestimate the LRR and may lead to inappropriate omission of radiotherapy. Unless other data show a clinically significant advantage of the RDS (Oncotype DX DCIS Score), the study data suggest that for women 50 years of age or older with DCIS size 2.5 cm or smaller, its use is not warranted.</description><identifier>ISSN: 1068-9265</identifier><identifier>ISSN: 1534-4681</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-019-07537-y</identifier><identifier>PMID: 31342373</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Aged, 80 and over ; Biomarkers, Tumor - genetics ; Breast ; Breast cancer ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Breast Oncology ; Breast surgery ; CARCINOMAS ; Endocrine therapy ; Estimates ; Female ; Follow-Up Studies ; Gene Expression Profiling ; Humans ; Incidence ; MAMMARY GLANDS ; Mastectomy, Segmental - adverse effects ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Recurrence, Local - diagnosis ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - etiology ; New York - epidemiology ; NOMOGRAMS ; Oncology ; PATIENTS ; Prognosis ; Radiation therapy ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Risk Assessment - methods ; SURGERY ; Surgical Oncology ; Survival Rate ; WOMEN</subject><ispartof>Annals of surgical oncology, 2019-10, Vol.26 (10), p.3282-3288</ispartof><rights>Society of Surgical Oncology 2019</rights><rights>Annals of Surgical Oncology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c447t-4d33f003d6a71699b883e3caf94ea83b1c1746ad2c3ec7059d74ebd161bf964c3</citedby><cites>FETCH-LOGICAL-c447t-4d33f003d6a71699b883e3caf94ea83b1c1746ad2c3ec7059d74ebd161bf964c3</cites><orcidid>0000-0001-9550-4647</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-019-07537-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-019-07537-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31342373$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22927591$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Van Zee, Kimberly J.</creatorcontrib><creatorcontrib>Zabor, Emily C.</creatorcontrib><creatorcontrib>Di Donato, Rosemarie</creatorcontrib><creatorcontrib>Harmon, Bryan</creatorcontrib><creatorcontrib>Fox, Jana</creatorcontrib><creatorcontrib>Morrow, Monica</creatorcontrib><creatorcontrib>Cody, Hiram S.</creatorcontrib><creatorcontrib>Fineberg, Susan A.</creatorcontrib><title>Comparison of Local Recurrence Risk Estimates After Breast-Conserving Surgery for DCIS: DCIS Nomogram Versus Refined Oncotype DX Breast DCIS Score</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
A ductal carcinoma in situ (DCIS) Nomogram integrating 10 clinicopathologic/treatment factors and a Refined DCIS Score (RDS) that incorporates a genomic assay and three clinicopathologic factors (Oncotype DX DCIS Score) are available to estimate DCIS 10-year local recurrence risk (LRR). This study compared these estimates.
Methods
Patients 50 years of age or older with DCIS size 2.5 cm or smaller and a genomic assay available were identified. An RDS within 1–2% of the range of Nomogram LRR estimates obtained by assuming use and non-use of endocrine therapy (Nomogram ± ET) was defined as concordant. Assuming a 10-year risk threshold of 10% for recommending radiation, Nomogram ± ET and RDS estimates were compared, and threshold concordance was determined.
Results
For 54 (92%) of 59 patients, the RDS and Nomogram ± ET LRR estimates were concordant. For the remaining 5 (8%) of the 59 patients, the RDS LRR estimates were lower than the Nomogram + ET estimates, with an absolute difference of 3–8%, and thus were discordant. For these five patients, the RDS estimates of 10-year LRR were lower than 10% (range 5–8%) and the Nomogram + ET estimates were 10% or higher (range 11–14%). These five patients with both discordant and threshold-discordant estimates all had close margins (≤ 2 mm).
Conclusions
Among 92% of women 50 years of age or older with DCIS size 2.5 cm or smaller, free-of-charge online Nomogram 10-year LRR estimates were concordant with those obtained using the commercially available RDS (> $4600). Among the 8% with discordant risk estimates, the RDS appeared to underestimate the LRR and may lead to inappropriate omission of radiotherapy. Unless other data show a clinically significant advantage of the RDS (Oncotype DX DCIS Score), the study data suggest that for women 50 years of age or older with DCIS size 2.5 cm or smaller, its use is not warranted.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomarkers, Tumor - genetics</subject><subject>Breast</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Breast Oncology</subject><subject>Breast surgery</subject><subject>CARCINOMAS</subject><subject>Endocrine therapy</subject><subject>Estimates</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gene Expression Profiling</subject><subject>Humans</subject><subject>Incidence</subject><subject>MAMMARY GLANDS</subject><subject>Mastectomy, Segmental - adverse effects</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - diagnosis</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>New York - epidemiology</subject><subject>NOMOGRAMS</subject><subject>Oncology</subject><subject>PATIENTS</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Risk Assessment - methods</subject><subject>SURGERY</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>WOMEN</subject><issn>1068-9265</issn><issn>1534-4681</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kcFuFSEUhonR2Fp9AReGxPUoDAwM7uq0tk1ubNKrxh1hmMN1ageuwJjMa_jEYudqd26AwHd-zvl_hF5S8obWvHmbKOGMV4SqisiGyWp5hI5pU664aOnjciairVQtmiP0LKVbQqhkpHmKjhhlvGaSHaNfXZj2Jo4peBwc3gRr7vAN2DlG8BbwzZi-4_OUx8lkSPjUZYj4fQSTctUFnyD-HP0Ob-e4g7hgFyI-66627-5X_DFMYRfNhL9ATHMqwm70MOBrb0Ne9oDPvh7EVn5rQ4Tn6IkzdwleHPYT9PnD-afustpcX1x1p5vKci5zxQfGHCFsEEZSoVTftgyYNU5xMC3rqaWSCzPUloGVpFGD5NAPVNDeKcEtO0GvV91QxtPJjhnsNxu8B5t1XataNoo-UPsYfsyQsr4Nc_SlscIIViylvC1UvVI2hpQiOL2PxbK4aEr0n7D0GpYuYen7sPRSil4dpOd-guFfyd90CsBWIJUnXwx--Ps_sr8BrvOfew</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Van Zee, Kimberly J.</creator><creator>Zabor, Emily C.</creator><creator>Di Donato, Rosemarie</creator><creator>Harmon, Bryan</creator><creator>Fox, Jana</creator><creator>Morrow, Monica</creator><creator>Cody, Hiram S.</creator><creator>Fineberg, Susan A.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>OTOTI</scope><orcidid>https://orcid.org/0000-0001-9550-4647</orcidid></search><sort><creationdate>20191001</creationdate><title>Comparison of Local Recurrence Risk Estimates After Breast-Conserving Surgery for DCIS: DCIS Nomogram Versus Refined Oncotype DX Breast DCIS Score</title><author>Van Zee, Kimberly J. ; Zabor, Emily C. ; Di Donato, Rosemarie ; Harmon, Bryan ; Fox, Jana ; Morrow, Monica ; Cody, Hiram S. ; Fineberg, Susan A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c447t-4d33f003d6a71699b883e3caf94ea83b1c1746ad2c3ec7059d74ebd161bf964c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomarkers, Tumor - genetics</topic><topic>Breast</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Breast Oncology</topic><topic>Breast surgery</topic><topic>CARCINOMAS</topic><topic>Endocrine therapy</topic><topic>Estimates</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gene Expression Profiling</topic><topic>Humans</topic><topic>Incidence</topic><topic>MAMMARY GLANDS</topic><topic>Mastectomy, Segmental - adverse effects</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - diagnosis</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>New York - epidemiology</topic><topic>NOMOGRAMS</topic><topic>Oncology</topic><topic>PATIENTS</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Risk Assessment - methods</topic><topic>SURGERY</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>WOMEN</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van Zee, Kimberly J.</creatorcontrib><creatorcontrib>Zabor, Emily C.</creatorcontrib><creatorcontrib>Di Donato, Rosemarie</creatorcontrib><creatorcontrib>Harmon, Bryan</creatorcontrib><creatorcontrib>Fox, Jana</creatorcontrib><creatorcontrib>Morrow, Monica</creatorcontrib><creatorcontrib>Cody, Hiram S.</creatorcontrib><creatorcontrib>Fineberg, Susan A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>OSTI.GOV</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van Zee, Kimberly J.</au><au>Zabor, Emily C.</au><au>Di Donato, Rosemarie</au><au>Harmon, Bryan</au><au>Fox, Jana</au><au>Morrow, Monica</au><au>Cody, Hiram S.</au><au>Fineberg, Susan A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Local Recurrence Risk Estimates After Breast-Conserving Surgery for DCIS: DCIS Nomogram Versus Refined Oncotype DX Breast DCIS Score</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2019-10-01</date><risdate>2019</risdate><volume>26</volume><issue>10</issue><spage>3282</spage><epage>3288</epage><pages>3282-3288</pages><issn>1068-9265</issn><issn>1534-4681</issn><eissn>1534-4681</eissn><abstract>Background
A ductal carcinoma in situ (DCIS) Nomogram integrating 10 clinicopathologic/treatment factors and a Refined DCIS Score (RDS) that incorporates a genomic assay and three clinicopathologic factors (Oncotype DX DCIS Score) are available to estimate DCIS 10-year local recurrence risk (LRR). This study compared these estimates.
Methods
Patients 50 years of age or older with DCIS size 2.5 cm or smaller and a genomic assay available were identified. An RDS within 1–2% of the range of Nomogram LRR estimates obtained by assuming use and non-use of endocrine therapy (Nomogram ± ET) was defined as concordant. Assuming a 10-year risk threshold of 10% for recommending radiation, Nomogram ± ET and RDS estimates were compared, and threshold concordance was determined.
Results
For 54 (92%) of 59 patients, the RDS and Nomogram ± ET LRR estimates were concordant. For the remaining 5 (8%) of the 59 patients, the RDS LRR estimates were lower than the Nomogram + ET estimates, with an absolute difference of 3–8%, and thus were discordant. For these five patients, the RDS estimates of 10-year LRR were lower than 10% (range 5–8%) and the Nomogram + ET estimates were 10% or higher (range 11–14%). These five patients with both discordant and threshold-discordant estimates all had close margins (≤ 2 mm).
Conclusions
Among 92% of women 50 years of age or older with DCIS size 2.5 cm or smaller, free-of-charge online Nomogram 10-year LRR estimates were concordant with those obtained using the commercially available RDS (> $4600). Among the 8% with discordant risk estimates, the RDS appeared to underestimate the LRR and may lead to inappropriate omission of radiotherapy. Unless other data show a clinically significant advantage of the RDS (Oncotype DX DCIS Score), the study data suggest that for women 50 years of age or older with DCIS size 2.5 cm or smaller, its use is not warranted.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31342373</pmid><doi>10.1245/s10434-019-07537-y</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9550-4647</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Biomarkers, Tumor - genetics Breast Breast cancer Breast Neoplasms - pathology Breast Neoplasms - surgery Breast Oncology Breast surgery CARCINOMAS Endocrine therapy Estimates Female Follow-Up Studies Gene Expression Profiling Humans Incidence MAMMARY GLANDS Mastectomy, Segmental - adverse effects Medicine Medicine & Public Health Middle Aged Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - etiology New York - epidemiology NOMOGRAMS Oncology PATIENTS Prognosis Radiation therapy RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Risk Assessment - methods SURGERY Surgical Oncology Survival Rate WOMEN |
| title | Comparison of Local Recurrence Risk Estimates After Breast-Conserving Surgery for DCIS: DCIS Nomogram Versus Refined Oncotype DX Breast DCIS Score |
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