A new study reported online by the Journal of the National Cancer Institute concluded that women with ductal carcinoma in situ (DCIS) that is the most common form of non-invasive breast cancer will have the opportunity to be more selective about their treatment in the future. This is a result of discovering a way to predict which women with DCIS are at risk of developing more invasive tumors later in life.
Following the medical histories of 1,162 women aged 40 and older who were diagnosed with DCIS and treated with lumpectomy, the researchers found two factors predictive of risk of developing invasive cancer within 8 years after a diagnosis of DSCI. These were the method by which the cancer was detected (lump or mammography) and the expression of several biomarkers (estrogen receptor, progesterone receptor, Ki67 antigen, p16, epidermal growth factor receptor-2, and cyclooxygenase-2). Results showed that a breast lump diagnosed as DSCI was more predictive of a higher risk of later invasive cancer than DSCI diagnosed by mammography. In addition, different combinations of biomarkers identified on the initial DSCI tissue were associated with different levels of risk of invasive cancer. Women who had high levels of p16, cyclooxygenase-2, and Ki67 were more likely to develop invasive cancer after their initial DCSI diagnoses and these markers will predict as far as 8 years in the future. One of the researchers said the findings show that the group of patients with the lowest risk has only a 2 percent chance of developing invasive cancer by 5 years and 4 percent chance at 8 years. He further said “This is an exciting and powerful beginning to be able to predict which pre-cancers will lie dormant and which will lead to invasive cancers. For the first time, we’ve identified that group of patients who have the lowest risk and the group at highest risk of developing invasive cancer. It’s a big step.”
