title: Prognostic classification of breast ductal carcinoma-in-situ.
abstract: We present a new prognostic classification designated the Van Nuys classification for ductal carcinoma-in-situ (DCIS). The classification combines high nuclear grade and comedo-type necrosis to predict clinical recurrence. Three groups of DCIS patients were defined by the presence or absence of high nuclear grade and comedo-type necrosis: 1--non-high-grade DCIS without comedo-type necrosis, 2--non-high-grade DCIS with comedo-type necrosis, 3--high-grade DCIS with or without comedo-type necrosis. There were 31 local recurrences in 238 patients after breast-conservation surgery 3.8% (3/80) in group 1, 11.1% (10/90) in group 2, and 26.5% (18/68) in group 3. The 8-year actuarial disease-free survivals were 93%, 84%, and 61%, respectively (all p < or = 0.05). The Van Nuys classification defines three distinct and easily recognisable groups, each of which has a different likelihood of local recurrence if treated with breast conservation.
authors.affiliation: Gloucestershire Royal Hospital, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Silverstein
authors.forename: D N
authors.initials: DN
authors.lastname: Poller
authors.forename: J R
authors.initials: JR
authors.lastname: Waisman
authors.forename: W J
authors.initials: WJ
authors.lastname: Colburn
authors.forename: A
authors.initials: A
authors.lastname: Barth
authors.forename: E D
authors.initials: ED
authors.lastname: Gierson
authors.forename: B
authors.initials: B
authors.lastname: Lewinsky
authors.forename: P
authors.initials: P
authors.lastname: Gamagami
authors.forename: D J
authors.initials: DJ
authors.lastname: Slamon
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000145:classification* / Q000473:pathology* / Q000628:therapy; D002278:Carcinoma in Situ / Q000145:classification* / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000145:classification* / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006801:Humans; D008408:Mastectomy; D015412:Mastectomy, Segmental; D009336:Necrosis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011446:Prospective Studies