{"id":3193,"date":"2020-12-28T00:00:00","date_gmt":"2020-12-28T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/21-gene-assay-and-breast-cancer-mortality-in-ductal-carcinoma-in-situ\/"},"modified":"2023-06-14T19:33:20","modified_gmt":"2023-06-14T23:33:20","slug":"21-gene-assay-and-breast-cancer-mortality-in-ductal-carcinoma-in-situ","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/21-gene-assay-and-breast-cancer-mortality-in-ductal-carcinoma-in-situ\/","title":{"rendered":"21-gene assay and breast cancer mortality in ductal carcinoma in situ"},"content":{"rendered":"<p><strong>Background <\/strong>&#x2014; The inability to identify individuals with ductal carcinoma in situ (DCIS) who are at risk of breast cancer (BC) mortality have hampered efforts to reduce the over-treatment of DCIS. The 21-gene Recurrence Score (RS) predicts distant metastases for individuals with invasive BC, but its prognostic utility in DCIS is unknown.<\/p>\n<p><strong>Methods <\/strong>&#x2014; We performed a population-based analysis of 1,362 individuals of DCIS aged &#x2264;75 years at diagnosis treated with breast-conserving therapy. We examined the association between a high RS (defined a priori as &gt; 25) and the risk of BC mortality by using a propensity score-adjusted model accounting for the competing risk of death from other causes, testing for interactions. All statistical tests were two-sided.<\/p>\n<p><strong>Results <\/strong>&#x2014; With 16 years median follow-up, 36 (2.6%) died of BC and 200 (14.7%) died of other causes. The median value of the RS was 15 (range = 0-84); 29.6% of individuals had a high RS. A high RS was associated with an 11-fold increased risk of BC mortality (HR = 11.27 95%CI = 3.00 to 42.33, p&lt;.001 in women &#x2264;50 years of age at diagnosis treated with BCS alone, culminating in a 9.4% (95%CI= 2.3 to 22.5) 20-year risk of BC death. For women with a high RS, treatment with RT was associated with a 71% (HR = 0.29, 95%CI = 0.10 to 0.89. p = .03) relative and a 5% absolute reduction in the 20-year cumulative risk of death from BC.<\/p>\n<p><strong>Conclusion <\/strong>&#x2014; The 21-gene RS predicts BC mortality in DCIS and combined with age (&#x2264;50 years) at diagnosis can identify individuals for whom RT reduces the risk of death from BC.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; The inability to identify individuals with ductal carcinoma in situ (DCIS) who are at risk of breast cancer (BC) mortality have hampered efforts to reduce the over-treatment of DCIS. The 21-gene Recurrence Score (RS) predicts distant metastases for individuals with invasive BC, but its prognostic utility in DCIS is unknown. Methods &#x2014; We [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-3193","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Rakovitch E, Sutradhar R, Nofech-Mozes S, Gu S, Fong C, Hanna W, Paszat L. <em>J Natl Cancer Inst<\/em>. 2021; 113(5):572-9. Epub 2020 Dec 28.","source_url":"https:\/\/doi.org\/10.1093\/jnci\/djaa179","ices_scientist":[1341,1370,1099],"site":[6733],"research_program":[6741],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"1BA085FD-DE13-4EC3-8213-4571320C3BAB","sitecore_item_name":"21-gene-assay-and-breast-cancer-mortality-in-ductal-carcinoma-in-situ","sitecore_field_values":"{\n  \"Title\": \"21-gene assay and breast cancer mortality in ductal carcinoma in situ\",\n  \"Short title\": \"21-gene assay and breast cancer\",\n  \"Summary\": \"The inability to identify individuals with ductal carcinoma in situ (DCIS) who are at risk of breast cancer (BC) mortality have hampered efforts to reduce the over-treatment of DCIS.\",\n  \"Citation\": \"<p>Rakovitch E, Sutradhar R, Nofech-Mozes S, Gu S, Fong C, Hanna W, Paszat L. <em>J Natl Cancer Inst<\/em>. 2021; 113(5):572-9. Epub 2020 Dec 28. DOI: <a href=\"https:\/\/doi.org\/10.1093\/jnci\/djaa179\" title=\"opens external link\">https:\/\/doi.org\/10.1093\/jnci\/djaa179<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background <\/strong>&mdash; The inability to identify individuals with ductal carcinoma in situ (DCIS) who are at risk of breast cancer (BC) mortality have hampered efforts to reduce the over-treatment of DCIS. The 21-gene Recurrence Score (RS) predicts distant metastases for individuals with invasive BC, but its prognostic utility in DCIS is unknown.<\/p>n<p><strong>Methods <\/strong>&mdash; We performed a population-based analysis of 1,362 individuals of DCIS aged &le;75 years at diagnosis treated with breast-conserving therapy. We examined the association between a high RS (defined a priori as &gt; 25) and the risk of BC mortality by using a propensity score-adjusted model accounting for the competing risk of death from other causes, testing for interactions. All statistical tests were two-sided.<\/p>n<p><strong>Results <\/strong>&mdash; With 16 years median follow-up, 36 (2.6%) died of BC and 200 (14.7%) died of other causes. The median value of the RS was 15 (range = 0-84); 29.6% of individuals had a high RS. A high RS was associated with an 11-fold increased risk of BC mortality (HR = 11.27 95%CI = 3.00 to 42.33, p&lt;.001 in women &le;50 years of age at diagnosis treated with BCS alone, culminating in a 9.4% (95%CI= 2.3 to 22.5) 20-year risk of BC death. For women with a high RS, treatment with RT was associated with a 71% (HR = 0.29, 95%CI = 0.10 to 0.89. p = .03) relative and a 5% absolute reduction in the 20-year cumulative risk of death from BC.<\/p>n<p><strong>Conclusion <\/strong>&mdash; The 21-gene RS predicts BC mortality in DCIS and combined with age (&le;50 years) at diagnosis can identify individuals for whom RT reduces the risk of death from BC.<\/p>\",\n  \"Research Programs\": \"{85DE96A6-4C96-40C7-8E6D-7597A0EB5F80}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{CFFF9366-6EFD-41AF-8E1E-5C38A65A0CE9}|{56BF24FA-D81E-4114-BF1F-4715A424E26C}|{F137150D-7BD5-4368-8FCC-FAF6D82891C4}\",\n  \"Posted Date\": \"20201228T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2020\/December\/21-gene-assay-and-breast-cancer-mortality-in-ductal-carcinoma-in-situ"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | 21-gene assay and breast cancer mortality in ductal carcinoma in situ<\/title>\n<meta name=\"description\" content=\"Background &#x2014; The inability to identify individuals with ductal carcinoma in situ (DCIS) who are at risk of breast cancer (BC) mortality have\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/21-gene-assay-and-breast-cancer-mortality-in-ductal-carcinoma-in-situ\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | 21-gene assay and breast cancer mortality in ductal carcinoma in situ\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; The inability to identify individuals with ductal carcinoma in situ (DCIS) who are at risk of breast cancer (BC) mortality have\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/21-gene-assay-and-breast-cancer-mortality-in-ductal-carcinoma-in-situ\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:33:20+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/21-gene-assay-and-breast-cancer-mortality-in-ductal-carcinoma-in-situ\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/21-gene-assay-and-breast-cancer-mortality-in-ductal-carcinoma-in-situ\\\/\",\"name\":\"ICES | 21-gene assay and breast cancer mortality in ductal carcinoma in situ\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2020-12-28T05:00:00+00:00\",\"dateModified\":\"2023-06-14T23:33:20+00:00\",\"description\":\"Background &#x2014; 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