Smith et al developed a prognostic score for patients with ductal carcinoma in situ (DCIS).
The score is similar to the University of Southern California/Van Nuys prognostic index. It differs by:
(1) not scoring the distance to the resection margin
(2) scoring from 0 to 2 instead of from 1 to 3
Parameters:
(1) age in years
(2) size in millimeters
(3) histologic grade
Parameter
Finding
Points
Age
> 60 years
0
40 to 60
1
< 40 years
2
size
<= 15 mm
0
16 to 40 mm
1
> 40 mm
2
histologic grade
low grade
0
intermediate grade
1
high grade
2
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk and the greater the need for aggressive management.
• A patient with a score of 4, 5 or 6 benefited the most from the addition of radiation therapy to breast conservation surgery, with benefits also seen with a score of 2 or 3.
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