DCISion time.

Headline: Endocrine therapy doesn’t appear to add much in the management of DCIS receiving radiation per genomic classifiers.

The Study: DCISionRT is a genomic classifier to help identify which women benefit most from adjuvant radiation following breast-conserving surgery for DCIS. This analysis aimed to use this tool to identify which women can pass on years of maintenance endocrine therapy, as well. Looking back at four prospective cohorts receiving DCISionRT scores (DS), a total of 926 women were classified into one of three categories: low risk (37%, low DS), elevated risk (43%, high DS and low clinical risk of residual disease), or high risk (20%, high DS and high clinical risk of residual disease). As expected, neither radiation nor endocrine therapy were associated with lower in-breast recurrence risk in the low risk group where it was 5.6% 10 years out from surgery alone. What’s more, there was no added benefit of endocrine therapy in the elevated and high risk groups receiving radiation, where in-breast recurrence rates at 10 years were 6.3% and 12.5%, respectively.

TBL: Using a genomic classifier, there appears to be little added benefit of endocrine therapy for low-risk DCIS omitting radiation and higher-risk DCIS receiving radiation. | Whitworth, ASCO 2022