title: Ductal carcinoma in situ: USC/Van Nuys Prognostic Index and the impact of margin status.
abstract: As our knowledge of ductal carcinoma in situ (DCIS) continues to evolve, treatment decision-making has become increasingly complex and controversial for both patients and physicians. Treatment options include mastectomy, and breast conservation with or without radiation therapy. Data produced from the randomized clinical trials for DCIS has provided the basis for important treatment recommendations, but are not without limitations. In this article, we review our prospectively collected database consisting of 1036 patients with DCIS treated at the Van Nuys Breast Center and the USC/Norris Comprehensive Cancer Center. We review the use of the USC/Van Nuys Prognostic Index, a clinical algorithm designed to assist physicians in selection of appropriate treatments, and examine the impact of margin status as a sole predictor of local recurrence.
authors.affiliation: USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA. melsilver@aol.com
authors.forename: Melvin J
authors.initials: MJ
authors.lastname: Silverstein
authors.forename: Claire
authors.initials: C
authors.lastname: Buchanan
mesh_terms: D000465:Algorithms; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000401:mortality*; D003131:Combined Modality Therapy; D003657:Decision Making; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D015999:Multivariate Analysis; D009336:Necrosis; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic