Dr. Plitcha concluded her discussion by saying, ‘So, in your practices today, clinical pathologic factors may not be adequate for assessing radiation benefit. And the 7-gene biosignature may provide superior prediction for 10-year risk and radiation benefit than standard risk models.’

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Troy Bremer, PhD; Pat Whitworth, MD; Chirag Shah, MD; Anne Peled, MD; and Karen Barbosa, DO, FACOS discuss the recently published randomized SweDCIS data and how they are utilizing DCISionRT in clinical practice.

Dr. Bremer kicked off the meeting with a discussion of the current challenge of overtreatment with radiation therapy for ductal carcinoma in situ (DCIS). “Specifically, about 80% of DCIS patients treated with breast conserving surgery (BCS), and no other adjuvant therapy, don’t recur. Yet, 80% - 90% of DCIS patients are treated with other adjuvant therapy, including radiation therapy (RT), following BCS due to a lack of confidence in who actually needs adjuvant therapy. This overtreatment substantially impacts quality of life for women with DCIS and results in a high cost of radiation to the health system.”

Under the standard treatment of DCIS, clinicians have historically used clinicopathology factors, such as age, size of tumor, grade, and margin status to determine low risk factors. Under the most recent National Comprehensive Cancer Network (NCCN) guidelines, if the patient and physician view the individual risk as ‘low,’ some patients may be treated by excision alone. But how do physicians detect low risk?

Genomics are a key part of the breast surgeon’s ability to offer personalized breast cancer care to treat appropriately without causing unnecessary side effects and optimize aesthetic and functional outcomes. Breast cancer surgeons are often the first point of contact for breast cancer patients and a trusted source for guidance on overall care. DCISionRT can provide valuable information and play an important role in the shared decision-making process.