Evidence map›Paper›PMID 31342373›Full record

ArticleAnnals of surgical oncology2019

Comparison of Local Recurrence Risk Estimates After Breast-Conserving Surgery for DCIS: DCIS Nomogram Versus Refined Oncotype DX Breast DCIS Score.

Kimberly J Van Zee, Emily C Zabor, Rosemarie Di Donato, Bryan Harmon, Jana Fox, Monica Morrow, Hiram S Cody, Susan A Fineberg

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
1.4field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 25 citations in OpenAlex.

  1. Review
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  4. Review
  5. Review
  6. Review
  7. Review
  8. The Clinical Utility of DCISionRTAnnals of surgical oncology · 2021
    Article
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  10. Review
  11. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Kimberly J Van ZeeBreast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. vanzeek@mskcc.org.ORCID http://orcid.org/0000-0001-9550-4647
Emily C ZaborBiostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Rosemarie Di DonatoDepartment of Pathology, Montefiore Medical Center, Bronx, NY, USA.
Bryan HarmonDepartment of Pathology, Montefiore Medical Center, Bronx, NY, USA.
Jana FoxDepartment of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA.
Monica MorrowBreast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Hiram S CodyBreast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Susan A FinebergDepartment of Pathology, Montefiore Medical Center, Bronx, NY, USA.
Memorial Sloan Kettering Cancer Center · USMontefiore Medical Center · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundA 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.

methodsPatients 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.

resultsFor 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).

conclusionsAmong 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.

Indexed as

NomogramsAgedAged, 80 and overBiomarkers, TumorBreast NeoplasmsFemaleFollow-Up StudiesGene Expression ProfilingHumansIncidenceMastectomy, SegmentalMiddle AgedNeoplasm Recurrence, LocalNew YorkPrognosisRisk AssessmentBiomarkers, Tumor

Identifiers

PMID31342373
PMCPMC6736743
OpenAlexW2963460268

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.