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Recurrence in DCIS

Centre for Cancer Prevention

Project Investigator: Profesor Jack Cuzick

Funding Body:  Cancer Research UK

Overview

Ductal carcinoma in situ (DCIS) is a pre-invasive breast cancer.

Almost thirty percent of DCIS cases treated with Breast Conserving Surgery (BCS) either recur or progress to frank invasive breast cancer (IBC).

Radiotherapy and Tamoxifen as adjuvant therapies reduce recurrences by half.

However, since a large majority of patients do not recur, adjuvant therapy is clearly an overtreatment for them.

Similarly, since some patients recur despite adjuvant therapy, their tumours are non-responsive to these treatments. This underscores the need for good prognostic and predictive markers since current prognostic factors are not sufficiently accurate.

Relevance

Breast cancer is the most common cancer among women and DCIS comprises approximately 20% of screen detected breast cancers in the developed world.

Good prognostic and predictive markers for DCIS will help to improve our management of this common disease.

Specific aims

  • To develop prognostic markers/models for DCIS treated with BCS.
  • To develop predictive markers/models for DCIS treated with BCS.

Research plan outline

We propose to use data and pathology material from the UK/ANZ DCIS trial to investigate candidate molecular markers by immunohistochemistry and analyse this data with clinicpathological variables to identify prognostic and predictive markers/models for management of DCIS.

As a part of this project, we have managed to collect pathology material from more than 900 patients enrolled in the UK/ANZ DCIS trial, this includes Formalin-Fixed Paraffin Embedded Tissue(FFPET) blocks of approximately 100 recurrences as well. FFPET blocks from more than 750 patients have been found to have tumour content suitable for research projects involving various techniques. Studies using immunohistochemical assays and mRNA expression profiling are nearing completion.

 
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