Normally, we don’t showcase studies for which the clinical applications are years away.

However, the stark terror which breast cancer causes for many women, and those who love them, makes this study important to note.

In this study, the researchers focused on the first stage, the pre-malignant stage. It is not uncommon to hear women say that they want to have a mastectomy to get the risk eliminated.

As this study shows, many women’s pre-malignancies will not advance to a full-blown, invasive cancer.

The challenge has been no one knew which women would remain stable and which ones would develop breast cancer.

An advance has been made.

The scientific disputes over mammograms, breast self-exam—what works, what doesn’t, what leads to over-treatment—have been headliners for the last several years. These leave women confused as to what to do and leaning heavily on their doctors to make sense out of these conflicts.

This study brings science one big step closer to being able to predict which women will need more invasive treatment—when available, it will save pain and suffering and many millions of dollars. Good medicine. Cost-effective.

• Only one in 10 women with pre-malignancies will go on to have a future cancer which requires treatment. This is called “invasive.”
• Researchers hope to go further in rating risks—called stratifying—so that they know still more about what risks call for what treatment, if any.
• The study says that the biomarkers used to identify this form of the disease are not looked for on a routine basis.
• It may not be practical for doctors to test for them.

Bring on better tests.

San Francisco Chronicle

“UCSF researchers have found a way to predict whether women with the earliest form of breast cancer are likely to develop deadly tumors – a significant discovery that might save women who aren’t at high risk from getting life-altering and unnecessary treatment. (Emphasis added)

More than 60,000 women every year are diagnosed with ductal carcinoma in situ, the most common type of noninvasive breast cancer, in which the early cancer cells are localized to the milk ducts. Almost all of these women undergo treatment involving either a lumpectomy or a complete mastectomy; very few of them develop invasive cancer or die within 10 years, the standard time for gauging cancer risk.

Researchers have long known that many women who choose to have lumpectomies or mastectomies will be over-treated for a disease that will never turn into full-blown cancer, but the alternative – waiting to see what happens – doesn’t sit well with most patients or doctors. Only about 5 percent of women with DCIS choose to get no treatment and continue monitoring the tissue.

The new study, which appears online today in the Journal of the National Cancer Institute, suggests that doctors may be able to use “biomarkers,” or biological indicators, in the body to determine a woman’s risk of developing cancer.

Source: San Francisco Chronicle, April 28, 2010

Citation: Journal of the National Cancer Institute. Published online on April 28, 2010. Publication scheduled: JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djq101