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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MDPI AG
2025-03-01
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| author | 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 |
| author_facet | 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 |
| author_sort | Marcelo Antonini |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-934c8f3193284c2288aa45a3e347e8e5 |
| institution | Kabale University |
| issn | 2075-1729 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj-art-934c8f3193284c2288aa45a3e347e8e52025-08-20T03:43:27ZengMDPI AGLife2075-17292025-03-0115343210.3390/life15030432Comparative Analyses of Van Nuys Prognostic Index and NCCN Guidelines in Ductal Carcinoma <i>In Situ</i> Treatment in a Brazilian HospitalMarcelo Antonini0Raissa Barros Vasconcelos1André Mattar2Mariana Pollone Medeiros3Marina Diógenes Teixeira4Andressa Gonçalves Amorim5Odair Ferraro6Larissa Chrispim de Oliveira7Marcellus do Nascimento Moreira Ramos8Francisco Pimentel Cavalcante9Felipe Zerwes10Marcelo Madeira11Eduardo de Camargo Millen12Antonio Luiz Frasson13Fabricio Palermo Brenelli14Gil Facina15Henrique Lima Couto16Luiz Henrique Gebrim17Department of Breast Surgery, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, Sao Paulo 04039-000, SP, BrazilDepartment of Breast Surgery, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, Sao Paulo 04039-000, SP, BrazilBBREAST—Brazilian Breast Association Team, Sao Paulo 01258-011, SP, BrazilDepartment of Breast Surgery, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, Sao Paulo 04039-000, SP, BrazilDepartment of Breast Surgery, Centro de Referência da Saúde da Mulher—Hospital da Mulher, Sao Paulo 01206-001, SP, BrazilDepartment of Breast Surgery, Centro de Referência da Saúde da Mulher—Hospital da Mulher, Sao Paulo 01206-001, SP, BrazilDepartment of Breast Surgery, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, Sao Paulo 04039-000, SP, BrazilDepartment of Breast Surgery, Centro de Referência da Saúde da Mulher—Hospital da Mulher, Sao Paulo 01206-001, SP, BrazilDepartment of Breast Surgery, Centro de Referência da Saúde da Mulher—Hospital da Mulher, Sao Paulo 01206-001, SP, BrazilDepartment of Breast Surgery, Hospital Geral de Fortaleza, Fortaleza 60150-160, CE, BrazilDepartment of Breast Surgery, Medical School of the Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, RS, BrazilDepartment of Breast Surgery, Faculdade Israelita de Ciências da Saúde Albert Einstein, Sao Paulo 05653-000, SP, BrazilDepartment of Breast Surgery, Americas Oncologia, Rio de Janeiro 22793-080, RJ, BrazilDepartment of Breast Surgery, Hospital Albert Einstein, Sao Paulo 05651-901, SP, BrazilDepartment of Breast Surgery, Universidade Estadual de Campinas (UNICAMP), Campinas 13082-859, SP, BrazilDepartment of Gynecology, Universidade Federal de Sao Paulo, Sao Paulo 04023-062, SP, BrazilDepartment of Breast Surgery, REDIMAMA-REDIMASTO, Belo Horizonte 30110-022, MG, BrazilDepartment of Breast Surgery, Hospital Beneficiencia Portuguesa, Sao Paulo 01438-000, SP, BrazilBackground: 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.https://www.mdpi.com/2075-1729/15/3/432ductal carcinoma <i>in situ</i>invasive breast cancerDCIS treatmentVan Nuys Prognostic IndexNational Comprehensive Cancer Network |
| spellingShingle | 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 Comparative Analyses of Van Nuys Prognostic Index and NCCN Guidelines in Ductal Carcinoma <i>In Situ</i> Treatment in a Brazilian Hospital Life ductal carcinoma <i>in situ</i> invasive breast cancer DCIS treatment Van Nuys Prognostic Index National Comprehensive Cancer Network |
| title | Comparative Analyses of Van Nuys Prognostic Index and NCCN Guidelines in Ductal Carcinoma <i>In Situ</i> Treatment in a Brazilian Hospital |
| title_full | Comparative Analyses of Van Nuys Prognostic Index and NCCN Guidelines in Ductal Carcinoma <i>In Situ</i> Treatment in a Brazilian Hospital |
| title_fullStr | Comparative Analyses of Van Nuys Prognostic Index and NCCN Guidelines in Ductal Carcinoma <i>In Situ</i> Treatment in a Brazilian Hospital |
| title_full_unstemmed | Comparative Analyses of Van Nuys Prognostic Index and NCCN Guidelines in Ductal Carcinoma <i>In Situ</i> Treatment in a Brazilian Hospital |
| title_short | Comparative Analyses of Van Nuys Prognostic Index and NCCN Guidelines in Ductal Carcinoma <i>In Situ</i> Treatment in a Brazilian Hospital |
| title_sort | comparative analyses of van nuys prognostic index and nccn guidelines in ductal carcinoma i in situ i treatment in a brazilian hospital |
| topic | ductal carcinoma <i>in situ</i> invasive breast cancer DCIS treatment Van Nuys Prognostic Index National Comprehensive Cancer Network |
| url | https://www.mdpi.com/2075-1729/15/3/432 |
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