A Biological Signature for Breast Ductal Carcinoma In Situ to Predict Radiotherapy Benefit and Assess Recurrence Risk

Abstract

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.

Validation of a Ductal Carcinoma In Situ Biomarker Profile for Risk of Recurrence after Breast-Conserving Surgery with and without Radiotherapy

“…The DS was calculated using seven IHC-evaluated biomarkers (COX-2, FOXA1, HER2, Ki-67, p16/INK4A, PR, and SIAH2) plus four clinicopathologic factors (age at diagnosis, tumor size, palpability, and surgical margin status) using a predetermined nonlinear algorithm designed to estimate the likelihood of TotBE risk for 10 years following treatment by BCS with or without adjuvant radiotherapy. The DS is a continuous number ranging from 0 to 10 with higher scores reflecting higher risk (15). Staining of protein biomarkers in the FFPE tissues was performed at the Clinical Laboratory Improvement Amendments-certified PreludeDx laboratory within 2 weeks of receipt, with scoring methods as described previously (15) and in the Supplementary Materials and Methods.…”

“…The DS is a continuous number ranging from 0 to 10 with higher scores reflecting higher risk (15). Staining of protein biomarkers in the FFPE tissues was performed at the Clinical Laboratory Improvement Amendments-certified PreludeDx laboratory within 2 weeks of receipt, with scoring methods as described previously (15) and in the Supplementary Materials and Methods. The testing was performed on intact FFPE tissue mounted slides, which preserved tissue architecture.…”

“…The DCISionRT DCIS test (PreludeDx) provides a single integrated risk assessment score by combining seven monoclonal protein markers assessed in formalin-fixed, paraffin-embedded (FFPE) tumor tissue with four clinicopathologic factors (15). The biologic signature was designed to provide a 10-year recurrence/progression risk assessment for patients with DCIS following BCS.…”

Long noncoding RNA BHLHE40‐AS1 promotes early breast cancer progression through modulating IL‐6/STAT3 signaling

“…The molecular mechanisms promoting DCIS progression to invasive disease remain largely unknown . Current diagnostic strategies focus on assessing the risk of recurrence after DCIS treatment but do not evaluate or define if a DCIS lesion is predicted to progress . Without a clinical method to identify which DCIS will progress, diagnosed women will undergo surgery and postoperative radiotherapy and/or endocrine therapy.…”

The challenge of avoiding over- and under-treatment in older women with ductal cancer in situ: A scoping review of existing knowledge gaps and a meta-analysis of real-world practice patterns

“…Recently, another biologic signature was developed and validated: The DCISion RT score seems to be a valid prognostic and predictive marker for DCIS, allowing for the identification of low-risk DCIS that would not benefit from radiotherapy, elevated risk cases where postoperative radiotherapy may result to risk reduction up to 70%, but it also reclassified patients deemed as low-risk by clinicopathological criteria such as screening detection, small size, non-high grade, no mass effect and vice versa [69].…”