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Case report
peer-reviewed

Improving Therapeutic Ratios with the Oncotype DX® Ductal Carcinoma In Situ (DCIS) Score



Abstract

Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer comprising nearly 25% of breast cancer diagnoses in the mammographic era. Current guidelines recommend breast-conserving surgery followed by adjuvant radiotherapy; however, controversy exists regarding the appropriateness of these recommendations. Some women with DCIS will never recur, which raises the concern of over-treatment. Conversely, a small number of women will develop invasive recurrences, raising concerns of under-treatment. Currently, several clinical and pathologic factors have been identified as prognostic markers for recurrence; however, these variables alone have been unable to identify low-risk and high-risk subgroups. The Oncotype DX® DCIS score is a multigene assay which allows for the addition of molecular information to traditional clinical and pathologic factors to help guide treatment decisions. Here, we present two case examples illustrating the use of the Oncotype DCIS score in clinical practice.



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Case report
peer-reviewed

Improving Therapeutic Ratios with the Oncotype DX® Ductal Carcinoma In Situ (DCIS) Score


Author Information

Nafisha Lalani Corresponding Author

Radiation Oncology, University of Toronto

Eileen Rakovitch

Sunnybrook Health Sciences Centre, University of Toronto


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.


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Case report
peer-reviewed

Improving Therapeutic Ratios with the Oncotype DX® Ductal Carcinoma In Situ (DCIS) Score

  • Author Information
    Nafisha Lalani Corresponding Author

    Radiation Oncology, University of Toronto

    Eileen Rakovitch

    Sunnybrook Health Sciences Centre, University of Toronto


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: April 21, 2017

    DOI

    10.7759/cureus.1185

    Cite this article as:

    Lalani N, Rakovitch E (April 21, 2017) Improving Therapeutic Ratios with the Oncotype DX® Ductal Carcinoma In Situ (DCIS) Score. Cureus 9(4): e1185. doi:10.7759/cureus.1185

    Publication history

    Received by Cureus: February 08, 2017
    Peer review began: February 15, 2017
    Peer review concluded: April 18, 2017
    Published: April 21, 2017

    Copyright

    © Copyright 2017
    Lalani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer comprising nearly 25% of breast cancer diagnoses in the mammographic era. Current guidelines recommend breast-conserving surgery followed by adjuvant radiotherapy; however, controversy exists regarding the appropriateness of these recommendations. Some women with DCIS will never recur, which raises the concern of over-treatment. Conversely, a small number of women will develop invasive recurrences, raising concerns of under-treatment. Currently, several clinical and pathologic factors have been identified as prognostic markers for recurrence; however, these variables alone have been unable to identify low-risk and high-risk subgroups. The Oncotype DX® DCIS score is a multigene assay which allows for the addition of molecular information to traditional clinical and pathologic factors to help guide treatment decisions. Here, we present two case examples illustrating the use of the Oncotype DCIS score in clinical practice.



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Create a free account to continue reading this article.

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Nafisha Lalani, M.D., Fellow Physician

Radiation Oncology, University of Toronto

For correspondence:
nafisha@gmail.com

Eileen Rakovitch, None

Sunnybrook Health Sciences Centre, University of Toronto

Nafisha Lalani, M.D., Fellow Physician

Radiation Oncology, University of Toronto

For correspondence:
nafisha@gmail.com

Eileen Rakovitch, None

Sunnybrook Health Sciences Centre, University of Toronto