Prognostic classification of breast ductal carcinoma-in-situ.
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.
Silverstein
M J
MJ
Gloucestershire Royal Hospital, UK.
Poller
D N
DN
Waisman
J R
JR
Colburn
W J
WJ
Barth
A
A
Gierson
E D
ED
Lewinsky
B
B
Gamagami
P
P
Slamon
D J
DJ
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