Zheng YZ, Qin HB, Li ZZ, et al. - It can be challenging to balance the risks of overtreatment vs undertreatment in cases with ductal carcinoma in situ with microinvasion (DCISM). In this study, the prognostic factors in patients with DCISM were investigated and a nomogram to predict breast cancer-specific survival (BCSS) was developed.

• The Surveillance, Epidemiology and End Results database yielded data of 5,438 total eligible breast cancer patients with a median and max survival time of 78 and 227 months, respectively.

• Patients who were diagnosed between 1988 and 2001, from African-American race, under 40 years of age, with higher tumor N stage, progesterone receptor-negative tumor, and received no surgery, were reported to exhibit poorer survival outcomes.

• Using the seven variables, the nomogram was constructed of patients with DCISM which could aid physicians to determine breast cancer patients that are more likely to benefit from more intensive treatment and follow-up.

• Better BCSS was observed in correlation with receiving chemotherapy, especially in patients with estrogen receptor (ER) negative, progesterone receptor (PR) negative and ER+PR-/ER-PR+ DCISM.