Published: 15 August 2013 at 15:23
Anglia Ruskin experts want introduction of new treatment model for DCIS patients
Breast cancer specialists at Anglia Ruskin University are proposing the introduction of a new model to provide safer treatment for patients with ductal carcinoma in situ (DCIS), the most common form of non-invasive breast cancer.
Writing in the latest edition of The Lancet Oncology journal, Professor John Benson and Professor Gordon Wishart state that therapies such as radiotherapy and tamoxifen, which can impair quality of life and increase health-care costs, are not necessary for all patients.
DCIS is an early form of breast cancer which is commonly detected by screening programmes and is not life-threatening. The surgeons believe that recent research into molecular markers can be used to develop a model to identify the low risk cases that may avoid harmful treatment and high risk cases where therapy can be maximised.
Over the past 30 years, clinicians have benefited from the use of predictive models to treat early invasive breast cancer, which incorporate not only tumour size, grade, and lymph node status, but also variables such as age and molecular markers such as the oestrogen and HER2 receptor. Professor Benson and Professor Wishart say that a similar approach would help with decision-making for DCIS patients after initial breast-conserving surgery (lumpectomy).
The most contentious issue surrounds radiotherapy and whether all patients undergoing breast-conserving surgery should receive it. The authors believe that if toxic effects of radiotherapy exceed any oncological gains amongst DCIS patients, it is likely to lead to a higher all-cause mortality rate.
Gordon Wishart, Professor of Cancer Surgery at Anglia Ruskin, said: