caa a22 4500 445338342 CHVBK 20180317142803.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1335-2 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1335-2 Analyzing the Risk of Recurrence after Mastectomy for DCIS: A New Use for the USC/Van Nuys Prognostic Index [Elektronische Daten] [Leah Kelley, Melvin Silverstein, Lisa Guerra] Background: Patients with ductal carcinoma in situ (DCIS) who are treated with mastectomy seldom recur locally or with metastatic disease. When patients with DCIS recur with invasive cancer, they are upstaged and their lives are threatened. We questioned whether histopathologic data could be used to predict these infrequent events. Methods: We reviewed a prospective database of 1,472 patients with pure DCIS. All patients were scored from 4 to 12 using the USC Van Nuys Prognostic Index, an algorithm based on DCIS size, nuclear grade, necrosis, margin width, and patient age. Probabilities of recurrence and death were calculated using the Kaplan-Meier method. Results: A total of 496 patients with pure DCIS were treated with mastectomy. None received any form of postmastectomy adjuvant treatment. Average follow-up was 83months. Eleven patients developed recurrences, all of whom scored 10-12 using the USC/VNPI. No patient who scored 4-9 recurred. All 11 patients who recurred had multifocal disease and comedo-type necrosis. The probability of disease recurrence after mastectomy for patients scoring 10-12 was 9.6% at 12years, compared with 0% for those scoring 4-9. There was no difference in overall survival. Conclusions: There were no recurrences among mastectomy patients who scored 4-9 using the USC/VNPI. Patients scoring 10-12 were significantly more likely to develop recurrence after mastectomy. At risk were young patients with large, high-grade, and multifocal or multicentric tumors. For every 100 patients with USC/VNPI scores of 10-12, 10 patients will recur by 12years and 2-3 will develop metastatic disease. Society of Surgical Oncology, 2010 Kelley Leah Department of Surgical Oncology, University of Southern California, Los Angeles, USA aut Silverstein Melvin Hoag Memorial Hospital Presbyterian, Breast Surgery, Newport Beach, USA aut Guerra Lisa Hoag Memorial Hospital Presbyterian, Breast Surgery, Newport Beach, USA aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 459-462 1068-9265 18:2<459 2011 18 10434 https://doi.org/10.1245/s10434-010-1335-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1335-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kelley Leah Department of Surgical Oncology, University of Southern California, Los Angeles, USA aut NATIONALLICENCE 700 1- Silverstein Melvin Hoag Memorial Hospital Presbyterian, Breast Surgery, Newport Beach, USA aut NATIONALLICENCE 700 1- Guerra Lisa Hoag Memorial Hospital Presbyterian, Breast Surgery, Newport Beach, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 459-462 1068-9265 18:2<459 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer