ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2016
Cost Effectiveness of the Oncotype DX DCIS Score for Guiding Treatment of Patients With Ductal Carcinoma In Situ.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Markov models for clinical decision-making in radiation oncology: A systematic review.Journal of medical imaging and radiation oncology · 2024Pooled it
- Systematic Review of the Cost Effectiveness of Breast Cancer Prevention, Screening, and Treatment Interventions.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Pooled it
- Review
- An early economic evaluation of active surveillance for low-risk ductal carcinomaFuture oncology (London, England) · 2024Article
- Tools to Guide Radiation Oncologists in the Management of DCIS.Healthcare (Basel, Switzerland) · 2024Review
- Personalizing the Treatment of Women with Ductal Carcinoma In Situ (DCIS) Using the DCIS Score: A Qualitative Study on Score Use.Current oncology (Toronto, Ont.) · 2024Article
- The art of war: using genetic insights to understand and harness radiation sensitivity in hematologic malignancies.Frontiers in oncology · 2024Review
- Article
- Molecular Signatures in Ductal Carcinoma In Situ (DCIS): A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Factors associated with ductal carcinoma in situ (DCIS) treatment patterns and patient-reported outcomes across a large integrated health network.Breast cancer research and treatment · 2023Article
- Ductal Carcinoma in Situ: Molecular Changes Accompanying Disease Progression.Journal of mammary gland biology and neoplasia · 2022Review
- Cost-Effectiveness of Adjuvant Treatment for Ductal Carcinoma In Situ.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021Article
- Pure Ductal Carcinoma In Situ of the Breast: Analysis of 270 Consecutive Patients Treated in a 9-Year Period.Cancers · 2021Article
- The Impact of Androgen Receptor and Histone Deacetylase 1 Expression on the Prognosis of Ductal CarcinomaJournal of breast cancer · 2020Article
- De-Escalation of Locoregional Therapy in Low-Risk Disease for DCIS and Early-Stage Invasive Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Review
- Cost Effectiveness of DCISionRT for Guiding Treatment of Ductal Carcinoma in Situ.JNCI cancer spectrum · 2020Article
- Article
- Quality of DCIS information on the internet: a content analysis.Breast cancer research and treatment · 2019Review
- A whole slide image-based machine learning approach to predict ductal carcinoma in situ (DCIS) recurrence risk.Breast cancer research : BCR · 2019Article
- Ductal carcinoma in situ of the breast: an update for the pathologist in the era of individualized risk assessment and tailored therapies.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2019Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose The Oncotype DX DCIS Score short form (DCIS Score) estimates the risk of an ipsilateral breast event (IBE) in patients with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery without adjuvant radiation therapy (RT). We determined the cost effectiveness of strategies using this test. Materials and Methods We developed a Markov model simulating 10-year outcomes for 60-year-old women eligible for the Eastern Cooperative Oncology Group E5194 study (cohort 1: low/intermediate-grade DCIS, ≤ 2.5 cm; cohort 2: high-grade DCIS, ≤ 1 cm) with each of five strategies: (1) no testing, no RT; (2) no testing, RT only for cohort 2; (3) no RT for low-grade DCIS, test for intermediate- and high-grade DCIS, RT for intermediate- or high-risk scores; (4) test all, RT for intermediate- or high-risk scores; and (5) no testing, RT for all. We used utilities and costs extracted from the literature and Medicare claims to determine incremental cost-effectiveness ratios and examined the number of women needed to irradiate per IBE prevented. Results No strategy using the DCIS Score was cost effective. The most cost-effective strategy (RT for none or RT for all) was sensitive to small differences between the utilities of receiving or not receiving RT and remaining without recurrence. The numbers needed to irradiate per IBE prevented were 10.5, 9.1, 7.5, and 13.1 for strategies 2 to 5, respectively, relative to strategy 1. Conclusion Strategies using the DCIS Score lowered the proportion of women undergoing RT per IBE prevented. However, no strategy incorporating the DCIS Score was cost effective. The cost effectiveness of RT was exquisitely utility sensitive, highlighting the importance of engaging patient preferences in this decision. Physicians should discuss trade-offs associated with omitting or adding adjuvant RT with each patient to maximize quality-of-life outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.