Patient prognostic score for ductal carcinoma in situ (DCIS) may be linked with the magnitude of the improvement in survival in patients treated with radiotherapy (RT) after breast-conserving surgery.1

These findings, which were published in the Journal of Clinical Oncology, suggested that decisions for RT may be tailored on the basis of patient factors, tumor biology, and prognostic score.

Researchers led by Yasuaki Sagara, MD, of Brigham and Women’s Hospital and Dana-Farber Cancer Institute in Boston, MA, conducted a retrospective longitudinal cohort study of 32 144 patients with DCIS diagnosed between 1988 and 2007 and treated with breast-conserving surgery. Among them, 20 329 were treated with RT and 11 815 were not.

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They evaluated for breast cancer mortality between the 2 groups using Cox proportional hazards model with propensity score weighting.

In total, they found 304 breast cancer-specific deaths over a median follow-up of 96 months, with a cumulative incidence of breast cancer mortality at 10 years in the weighted cohorts of 1.8% in the RT group, and 2.1% in the non-RT group.

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The researchers only found significant improvements in survival in the RT group compared with the non-RT group among patients with higher nuclear grade, younger age, and larger tumor size. Magnitude of survival difference with RT was significantly correlated with prognostic score.


  1. Sagara Y, Freedman RA, Vaz-Luis I, et al. Patient prognostic score and associations with survival improvement offered by Radiotherapy after breast-conserving surgery for ductal carcinoma in situ: a population-based longitudinal cohort study [published online ahead of print February 1, 2016]. J Clin Oncol. doi: 10.1200/JCO.2015.65.1869.