DCIS: Who gets radiotherapy
Association of Breast Surgery ePoster Library. Roche N. 05/15/17; 166282; P099
Nicola Roche
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Abstract
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1. Introduction: Most patients with ductal carcinoma in situ (DCIS) are treated with breast conserving surgery (BCS) and adjuvant radiotherapy (RT). The absolute benefit of RT on subgroups of DCIS may be small. The Van Nuys Prognostic Index (VNPI) is a tool designed to predict local recurrence (LR) and guide decisions regarding radiotherapy. Our aim was to examine the relationship between VNPI score and radiotherapy decision.
Methods: Retrospective review of 408 patient records with a coding diagnosis of DCIS from 2013-2015 was performed; 63 met our inclusion criteria.
Statistical analysis was performed using the two sample T test with unequal variances.
Results: In 20% (13/63), the MDT recommended 'not for RT' (VNPI 5-8). In 37% (23/63), the MDT recommended 'discuss RT' (VNPI 4-10). Of these 23 patients, 61% (n=14) decided to have radiotherapy and the range of VNPI in this group was 7-10. The remaining 43% (n=27) received a 'recommend RT' from the MDT (VNPI 5-10). Of these, 24 patients proceeded to RT.
Overall, 37 patients received RT (VNPI 6-10), 26 patients did not (VNPI 4-9). Mean VNPI scores were also significantly different (p=0.0001) between MDT decision groups, with 'discuss RT' or 'recommend RT' both higher than deciding not to give RT.
Conclusion: Most patients with DCIS are offered adjuvant radiotherapy. The VNPI, whilst only validated in one centre appears to influence the decision to recommend and give RT in our centre.
Methods: Retrospective review of 408 patient records with a coding diagnosis of DCIS from 2013-2015 was performed; 63 met our inclusion criteria.
Statistical analysis was performed using the two sample T test with unequal variances.
Results: In 20% (13/63), the MDT recommended 'not for RT' (VNPI 5-8). In 37% (23/63), the MDT recommended 'discuss RT' (VNPI 4-10). Of these 23 patients, 61% (n=14) decided to have radiotherapy and the range of VNPI in this group was 7-10. The remaining 43% (n=27) received a 'recommend RT' from the MDT (VNPI 5-10). Of these, 24 patients proceeded to RT.
Overall, 37 patients received RT (VNPI 6-10), 26 patients did not (VNPI 4-9). Mean VNPI scores were also significantly different (p=0.0001) between MDT decision groups, with 'discuss RT' or 'recommend RT' both higher than deciding not to give RT.
Conclusion: Most patients with DCIS are offered adjuvant radiotherapy. The VNPI, whilst only validated in one centre appears to influence the decision to recommend and give RT in our centre.
1. Introduction: Most patients with ductal carcinoma in situ (DCIS) are treated with breast conserving surgery (BCS) and adjuvant radiotherapy (RT). The absolute benefit of RT on subgroups of DCIS may be small. The Van Nuys Prognostic Index (VNPI) is a tool designed to predict local recurrence (LR) and guide decisions regarding radiotherapy. Our aim was to examine the relationship between VNPI score and radiotherapy decision.
Methods: Retrospective review of 408 patient records with a coding diagnosis of DCIS from 2013-2015 was performed; 63 met our inclusion criteria.
Statistical analysis was performed using the two sample T test with unequal variances.
Results: In 20% (13/63), the MDT recommended 'not for RT' (VNPI 5-8). In 37% (23/63), the MDT recommended 'discuss RT' (VNPI 4-10). Of these 23 patients, 61% (n=14) decided to have radiotherapy and the range of VNPI in this group was 7-10. The remaining 43% (n=27) received a 'recommend RT' from the MDT (VNPI 5-10). Of these, 24 patients proceeded to RT.
Overall, 37 patients received RT (VNPI 6-10), 26 patients did not (VNPI 4-9). Mean VNPI scores were also significantly different (p=0.0001) between MDT decision groups, with 'discuss RT' or 'recommend RT' both higher than deciding not to give RT.
Conclusion: Most patients with DCIS are offered adjuvant radiotherapy. The VNPI, whilst only validated in one centre appears to influence the decision to recommend and give RT in our centre.
Methods: Retrospective review of 408 patient records with a coding diagnosis of DCIS from 2013-2015 was performed; 63 met our inclusion criteria.
Statistical analysis was performed using the two sample T test with unequal variances.
Results: In 20% (13/63), the MDT recommended 'not for RT' (VNPI 5-8). In 37% (23/63), the MDT recommended 'discuss RT' (VNPI 4-10). Of these 23 patients, 61% (n=14) decided to have radiotherapy and the range of VNPI in this group was 7-10. The remaining 43% (n=27) received a 'recommend RT' from the MDT (VNPI 5-10). Of these, 24 patients proceeded to RT.
Overall, 37 patients received RT (VNPI 6-10), 26 patients did not (VNPI 4-9). Mean VNPI scores were also significantly different (p=0.0001) between MDT decision groups, with 'discuss RT' or 'recommend RT' both higher than deciding not to give RT.
Conclusion: Most patients with DCIS are offered adjuvant radiotherapy. The VNPI, whilst only validated in one centre appears to influence the decision to recommend and give RT in our centre.
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