Prognostic Factors for DCIS

With the introduction of population wide breast cancer screening programs DCIS detection has risen from 2% of all breast cancer to 20% in a little under three decades. Current practice guidelines for DCIS treatment recommend mastectomy or breast conserving surgery with radiation, and consideration of endocrine therapy. While DCIS is considered a true precursor to invasive breast cancer, multiple lines of evidence suggest that not all DCIS cases would progress to invasive breast cancer if left untreated. Improving the ability to discriminate indolent DCIS from clinically relevant DCIS is an urgent priority for improving the breast cancer screening process by reducing overtreatment.

The VBCSS has partnered with collaborators in multiple UVM Departments to study the molecular characterization of screen-detected breast cancer, including DCIS, as part of the National Cancer Institute's Consortium for Molecular and Cellular Characterization of Screen-Detected Lesions.  We have assembled a multi-disciplinary research team to address this problem, including experts in the basic, clinical, and population sciences. Our ultimate goal is to develop prognostic markers that will enable personalized management strategies for DCIS, such that the benefits of early detection are realized while eliminating unnecessary treatment and side effects.

We are currently focusing on the following research questions:

  • Are there molecular profiles identified in symptom-detected breast cancers that can discriminate indolent vs. aggressive screen-detected breast cancers?
  • Can we identify aspects of the DCIS tumor microenvironment that are predictive of recurrence?

Important Collaborators in this work include: