{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:48:54Z","timestamp":1793134134659,"version":"4.5.0"},"reference-count":61,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Ductal carcinoma in situ (DCIS), especially in the era of mammographic screening, is a commonly diagnosed breast tumor. Despite the low breast cancer mortality risk, management with breast conserving surgery (BCS) and radiotherapy (RT) is the prevailing treatment approach in order to reduce the risk of local recurrence (LR), including invasive LR, which carries a subsequent risk of breast cancer mortality. However, reliable and accurate individual risk prediction remains elusive and RT continues to be standardly recommended for most women with DCIS. Three molecular biomarkers have been studied to better estimate LR risk after BCS\u2014Oncotype DX DCIS score, DCISionRT Decision Score and its associated Residual Risk subtypes, and Oncotype 21-gene Recurrence Score. All these molecular biomarkers represent important efforts towards improving predicted risk of LR after BCS. To prove clinical utility, these biomarkers require careful predictive modeling with calibration and external validation, and evidence of benefit to patients; on this front, further research is needed. Most trials do not incorporate molecular biomarkers in evaluating de-escalation of therapy for DCIS; however, one\u2014the Prospective Evaluation of Breast-Conserving Surgery Alone in Low-Risk DCIS (ELISA) trial\u2014incorporates the Oncotype DX DCIS score in defining a low-risk population and is an important next step in this line of research.<\/jats:p>","DOI":"10.3390\/curroncol30060433","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T02:26:56Z","timestamp":1686709616000},"page":"5795-5806","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Can Molecular Biomarkers Help Reduce the Overtreatment of DCIS?"],"prefix":"10.3390","volume":"30","author":[{"given":"Ezra","family":"Hahn","sequence":"first","affiliation":[{"name":"Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8279-0621","authenticated-orcid":false,"given":"Danielle","family":"Rodin","sequence":"additional","affiliation":[{"name":"Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinku","family":"Sutradhar","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Nofech-Mozes","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Department of Pathology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Trebinjac","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence Frank","family":"Paszat","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada"},{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9647-2851","authenticated-orcid":false,"given":"Eileen","family":"Rakovitch","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.2105\/AJPH.87.7.1103","article-title":"Mammography screening for women aged 40 through 49\u2014A guidelines saga and a clarion call for informed decision making","volume":"87","author":"Ernster","year":"1997","journal-title":"Am. 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