Tumor DNA Testing To Help Guide Treatment For DCIS
PITTSBURGH (KDKA) – For women with a type of breast cancer called ductal carcinoma in situ, or DCIS, a new test is available to help guide treatment and determine if radiation is the proper course of action.
“So there is now a question, do we need to treat all of those patients who have DCIS followed by a lumpectomy with radiation therapy when the tumors are small and in their infancy?” Allegheny General Hospital cancer surgeon Dr. Thomas Julian said. “Are there tumors that are of such low risk, that just surgery alone might be enough to take care of it?”
If a woman is at high risk of recurrence, she would benefit from radiation therapy to prevent that.
Up until now, there hasn’t been a way to figure out who is in this high risk group. So, it’s standard for everyone to have the lump removed followed by radiation.
Unfortunately, radiation can only be given once in a patient’s lifetime because of possible scarring. If the cancer comes back, it’s no longer a treatment option. It would be better to put it off if a woman’s risk is low.
A new test can be helpful to figure out risk. It looks at the DNA of the cancer cells to see which genes are turned on, and how well the cancer would respond.
“You can determine through genetic interpretation of the tumor that you can categorize a patient’s risk of the cancer coming back into a low, an intermediate, and a high risk, and possibly alter the therapies that that patient may need,” Dr. Julian said.
This is a spin-off of a test developed here in Pittsburgh.
“Having something else come out off of this that we know kind of validates the integrity of genomic interpretation of tumors, it’s a great thing,” Dr. Julian said. “We’re happy that it was work that was built on top of what was initiated with our cooperative group.”
This test becomes available to the public today.
Because of a type of lab test exemption, it has not gone before the FDA. Some critics say it needs more validation with larger numbers of patients, and with outcomes compared against women who did get radiation.