Residual Disease Breast Cancer Following Therapy Model

Description

Ratanwichitrasin et al developed a model for identify a woman treated for ductal carcinoma in situ (DCIS) who may have residual disease. This can help to identify a patient who may benefit from more aggressive management. The authors are from the Cleveland Clinic.

Parameters:

(1) reason for presentation (mammogram vs clinical)

(2) multifocal or extensive disease

(3) comedo pattern

(4) margins

Presentation	Multifocal or Extensive	Comedo	Margins	Percent Residual DCIS
imaging	absent	absent	negative	1.5%
imaging	absent	absent	close	5%
imaging	absent	absent	positive or unknown	11%
imaging	absent	present	negative	4%
imaging	absent	present	close	12.5%
imaging	absent	present	positive or unknown	25%
imaging	present	absent	negative	10.5%
imaging	present	absent	close	29%
imaging	present	absent	positive or unknown	48%
imaging	present	present	negative	24%
imaging	present	present	close	53%
imaging	present	present	positive or unknown	72%
clinical	absent	absent	negative	11%
clinical	absent	absent	close	30%
clinical	absent	absent	positive or unknown	49%
clinical	absent	present	negative	25%
clinical	absent	present	close	54%
clinical	absent	present	positive or unknown	72%
clinical	present	absent	negative	49%
clinical	present	absent	close	77%
clinical	present	absent	positive or unknown	88%
clinical	present	present	negative	72%
clinical	present	present	close	90%
clinical	present	present	positive or unknown	95%

where:

• The percentages for positive margins and unknown margins were fairly close to each other so were combined.

• Reasons for clinical presentation: palpable mass, nipple discharge, other.

• A close margin was < 2 mm while negative margin was >= 2 mm.

• Comedo is one of the histologic patterns for DCIS with central necrosis, associated with high grade disease.

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Description

Specialty

Objective

ICD-10

Model of Ratanawichitrasin et al for Predicting the Likelihood of Residual Ductal Carcinoma in Situ (DCIS) Following Therapy

Purpose: To predict the likelihood of a woman treated for DCIS having residual disease using the model of Ratanwichitrasin et al.

Description

Specialty

Objective

ICD-10