{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:41:29Z","timestamp":1790293289789,"version":"4.1.0"},"reference-count":83,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T00:00:00Z","timestamp":1656720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cancer Research UK","award":["ref.C38317\/A24043"],"award-info":[{"award-number":["ref.C38317\/A24043"]}]},{"name":"KWF Dutch Cancer Society","award":["ref.C38317\/A24043"],"award-info":[{"award-number":["ref.C38317\/A24043"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Even though Ductal Carcinoma in Situ (DCIS) can potentially be an invasive breast cancer (IBC) precursor, most DCIS lesions never will progress to IBC if left untreated. Because we cannot predict yet which DCIS lesions will and which will not progress, almost all women with DCIS are treated by breast-conserving surgery +\/\u2212 radiotherapy, or even mastectomy. As a consequence, many women with non-progressive DCIS carry the burden of intensive treatment without any benefit. Multiple decision support tools have been developed to optimize DCIS management, aiming to find the balance between over- and undertreatment. In this systematic review, we evaluated the quality and added value of such tools. A systematic literature search was performed in Medline(ovid), Embase(ovid), Scopus and TRIP. Following the PRISMA guidelines, publications were selected. The CHARMS (prediction models) or IPDAS (decision aids) checklist were used to evaluate the tools\u2019 methodological quality. Thirty-three publications describing four decision aids and six prediction models were included. The decision aids met at least 50% of the IPDAS criteria. However, most lacked tools to facilitate discussion of the information with healthcare providers. Five prediction models quantify the risk of an ipsilateral breast event after a primary DCIS, one estimates the risk of contralateral breast cancer, and none included active surveillance. Good quality and external validations were lacking for all prediction models. There remains an unmet clinical need for well-validated, good-quality DCIS risk prediction models and decision aids in which active surveillance is included as a management option for low-risk DCIS.<\/jats:p>","DOI":"10.3390\/cancers14133259","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T11:12:35Z","timestamp":1656760355000},"page":"3259","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prediction Models and Decision Aids for Women with Ductal Carcinoma In Situ: A Systematic Literature Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8176-9684","authenticated-orcid":false,"given":"Ren\u00e9e","family":"Schmitz","sequence":"first","affiliation":[{"name":"Department of Molecular Pathology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5677-1934","authenticated-orcid":false,"given":"Erica","family":"Wilthagen","sequence":"additional","affiliation":[{"name":"Department of Scientific Information Service, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederieke","family":"van Duijnhoven","sequence":"additional","affiliation":[{"name":"Department of Surgery, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marja","family":"van Oirsouw","sequence":"additional","affiliation":[{"name":"Borstkanker Vereniging Nederland, 3511 DT Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Verschuur","sequence":"additional","affiliation":[{"name":"Borstkanker Vereniging Nederland, 3511 DT Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lynch","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Duke University, Durham, NC 27708, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinaa","family":"Punglia","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Duke University, Durham, NC 27708, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle","family":"Wesseling","sequence":"additional","affiliation":[{"name":"Department of Molecular Pathology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"},{"name":"Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Pathology, Nethelands Cancer Institute, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjanka","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Molecular Pathology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-949X","authenticated-orcid":false,"given":"Eveline","family":"Bleiker","sequence":"additional","affiliation":[{"name":"Department of Psycho-Oncology and Epidemiology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0016-4972","authenticated-orcid":false,"given":"Ellen","family":"Engelhardt","sequence":"additional","affiliation":[{"name":"Department of Psycho-Oncology and Epidemiology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Grand Challenge PRECISION Consortium","sequence":"additional","affiliation":[{"name":"Department of Molecular Pathology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21551","article-title":"Cancer statistics, 2019","volume":"69","author":"Siegel","year":"2019","journal-title":"CA Cancer J. 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