Evidence map›Paper›PMID 33830392›Full record

ArticleBreast cancer research and treatment2021

DUCHESS: an evaluation of the ductal carcinoma in situ score for decisions on radiotherapy in patients with low/intermediate-risk DCIS.

Eileen Rakovitch, Sameer Parpia, Anne Koch, Laval Grimard, Hany Soliman, Christiaan Stevens, Francisco Perera, Iwa Kong, Senti Senthelal, Margaret Anthes and 6 more

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In one paragraph

Article in Breast cancer research and treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 28% 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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Quality of life issues in patients with ductal carcinoma in situ: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Pooled it
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  11. Addressing the problem of overtreatment in breast cancer.Expert review of anticancer therapy · 2022
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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

16 authors at 11 institutions in 1 country.

Eileen RakovitchSunnybrook Health Sciences Centre, University of Toronto, T Wing 2075 Bayview Avenue, Toronto, ON, Canada. eileen.rakovitch@sunnybrook.ca.ORCID http://orcid.org/0000-0001-9647-2851
Sameer ParpiaJuravinski Cancer Centre, McMaster University, 699 Concession Street, Hamilton, ON, Canada.
Anne KochPrincess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
Laval GrimardThe Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada.
Hany SolimanSunnybrook Health Sciences Centre, University of Toronto, T Wing 2075 Bayview Avenue, Toronto, ON, Canada.
Christiaan StevensRoyal Victoria Regional Health Centre, Barrie, ON, Canada.
Francisco PereraLondon Regional Cancer Centre, University of Western Ontario, London, ON, Canada.
Iwa KongJuravinski Cancer Centre, McMaster University, 699 Concession Street, Hamilton, ON, Canada.
Senti SenthelalTrillium Health Partners, Mississauga, ON, Canada.
Margaret AnthesThunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada.
Ericka WiebeCross Cancer Institute, University of Alberta, Edmonton, AB, Canada.
Jeffrey CaoTom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada.
Mira GoldbergJuravinski Cancer Centre, McMaster University, 699 Concession Street, Hamilton, ON, Canada.
Sally SmithBC Cancer Agency, University of British Columbia, Victoria, BC, Canada.
Luciana SpadaforaJuravinski Cancer Centre, McMaster University, 699 Concession Street, Hamilton, ON, Canada.
Timothy J WhelanJuravinski Cancer Centre, McMaster University, 699 Concession Street, Hamilton, ON, Canada. whelan@hhsc.ca.
Juravinski Cancer Centre · CASunnybrook Health Science Centre · CABC Cancer Agency · CARoyal Victoria Regional Health Centre · CAThunder Bay Regional Health Sciences Centre · CATrillium Health Centre · CAUniversity of Alberta · CAUniversity of Calgary · CAUniversity of Ottawa · CAUniversity of Toronto · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIdentification of women with DCIS who have a very low risk of local recurrence risk (LRR) after breast-conserving surgery (BCS) is needed to de-escalate therapy. We evaluated the impact of 10-year LRR estimates after BCS, calculated by the integration of a 12-gene molecular expression assay (Oncotype Breast DCIS Score

methodsProspective cohort study of women with DCIS treated with BCS. Eligibility criteria were as follows: age > 45 years, tumor ≤ 2.5 cm, and margins ≥ 1 mm. Radiation oncologists provided 10-year LRR estimates without RT and recommendation for RT pre- and post-assay. Primary outcome was change in RT recommendation.

results217 patients were evaluable, with mean age = 63 years, mean tumor size = 1.1 cm, and mean DCIS Score = 32; 140 (64%) were in the low-risk (<39), 32 (15%) were in the intermediate-risk (39-54), and 45 (21%) were in the high-risk groups (≥55). The assay led to a change in treatment recommendation in 76 (35.2%) (95%CI 29.1-41.8%) patients. RT recommendations decreased from 79% pre-assay to 50% post-assay (difference = 29%; 95%CI 22-35%) due to a significant increase in the proportion of patients with a predicted low LRR (< 10%) post-assay and recommendations to omit RT for those with a low predicted risk. The assay was associated with improved patient satisfaction and reduced decisional conflict.

conclusionThe DCIS Score assay combined with CPFs identified more women with an estimated low (<10%) 10-yr LR risk after BCS, leading to a significant decrease in recommendations for RT compared to estimates based on CPFs alone.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, Intraductal, NoninfiltratingFemaleHumansMastectomy, SegmentalMiddle AgedNeoplasm Recurrence, LocalProspective StudiesAssayDCISDe-escalationDuctal carcinoma in situGenomicRadiotherapy

Identifiers

PMID33830392
OpenAlexW3148244480

What OpenQuestion holds

Textmetadata
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.