Comparative Analyses of Van Nuys Prognostic Index and NCCN Guidelines in Ductal Carcinoma <i>In Situ</i> Treatment in a Brazilian Hospital

Comparative Analyses of Van Nuys Prognostic Index and NCCN Guidelines in Ductal Carcinoma <i>In Situ</i> Treatment in a Brazilian Hospital

Background: Ductal carcinoma <i>in situ</i> (DCIS) is a precursor of invasive breast cancer and its early diagnosis and treatment are essential to prevent progression and recurrences. Risk stratification guidelines, such as the Van Nuys Prognostic Index (VNPI) and those by the National C...

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Main Authors: Marcelo Antonini, Raissa Barros Vasconcelos, André Mattar, Mariana Pollone Medeiros, Marina Diógenes Teixeira, Andressa Gonçalves Amorim, Odair Ferraro, Larissa Chrispim de Oliveira, Marcellus do Nascimento Moreira Ramos, Francisco Pimentel Cavalcante, Felipe Zerwes, Marcelo Madeira, Eduardo de Camargo Millen, Antonio Luiz Frasson, Fabricio Palermo Brenelli, Gil Facina, Henrique Lima Couto, Luiz Henrique Gebrim
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Life
Subjects:
ductal carcinoma <i>in situ</i>
invasive breast cancer
DCIS treatment
Van Nuys Prognostic Index
National Comprehensive Cancer Network
Online Access:https://www.mdpi.com/2075-1729/15/3/432
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Summary:Background: Ductal carcinoma <i>in situ</i> (DCIS) is a precursor of invasive breast cancer and its early diagnosis and treatment are essential to prevent progression and recurrences. Risk stratification guidelines, such as the Van Nuys Prognostic Index (VNPI) and those by the National Comprehensive Cancer Network (NCCN), help guide appropriate treatment. This study compares VNPI recommendations for DCIS patients treated at Hospital do Servidor Público Estadual de São Paulo (HSPE) with NCCN guidelines, focusing on treatment conducted and recurrence rates. Methods: This retrospective, cross-sectional study reviewed medical records of 145 patients treated for DCIS at HSPE between January 1996 and June 2022, with a mean follow-up of 60.3 months. Results: Based on VNPI, 38.8% were low risk, 53.2% intermediate risk, and 7.8% high risk. NCCN guidelines classified only 12.9% as low risk and 87.1% as high risk. Treatment included breast-conserving surgery (BCS) with radiotherapy (43.1%), BCS alone (38.8%), and mastectomy (18.1%). There were 18 recurrences (15.5%): 5.2% as DCIS and 10.3% as invasive cancer. Of these recurrences, 5.6% occurred in patients who, according to NCCN, would have received BCS with radiotherapy or mastectomy. Conclusion: By integrating the VNPI with NCCN treatment guidelines, the NCCN’s recommendations could potentially reduce local recurrence rates by 5.6%. However, further studies are necessary to evaluate the long-term impact of these guidelines on overall survival outcomes.
ISSN:2075-1729

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