Aggressive Form of Breast Cancer ID’d through New Test

Currently, when a woman receives a diagnosis with the earliest stage of breast cancer, called ductal cell carcinoma in situ, there is no way to tell if it is going to be aggressive or not. Because of this reason, to be safe, most patients undergo the most aggressive form of treatment. However, a new method that combines math with fluorescent microscopy can predict if a person’s particular type of cancer is going to be aggressive or not.

New Method

The new method, called biomarker ratio imaging microscopy, or BRIM, is the result of work from researchers at the University of Michigan who describe how they used it to identify aggressive types of ductal cell carcinoma in situ (DCIS) in a study that was published in the online journal Scientific Reports.

One of the team, Howard R. Petty, professor of ophthalmology and visual sciences and of microbiology and immunology, explains how a patient with DCIS typically goes through treatment as if the cancer is invasive. This is easy to understand he said and added, “When women hear breast cancer, they’re petrified. And physicians are keenly concerned about outcomes as well. But, DCIS is not the same disease for everyone. If we can identify potentially non-aggressive lesions, perhaps those women don’t need aggressive treatment.”

BRIM technology combines a traditional microscope that pathologists use to examine tissue with mathematical analysis. The technique compares levels of different biomarkers, which can be seen as different fluorescent colors in stained tissue under a microscope.

How Can You Know if DCIS Will Become Invasive?

Ductal carcinoma in situ is a noninvasive condition in which abnormal cells are found in the milk ducts of the breast. In situ means the cells have not spread to any surrounding tissues in the breast and that it’s localized to the milk duct.

In some situations, DCIS could become aggressive and spread to the surrounding tissues, but currently, pathologists have no way to discern which lesions could become serious.

Long-term studies of women whose DCIS lesions were untreated because they were originally misdiagnosed as benign found that 25 to 35 percent of them were diagnosed with invasive breast cancer in the decade following diagnosis.

DCIS can appear as a mass that can be felt manually, but it is most often detected on a mammogram, where it shows up as tiny white dots signifying calcium deposits. The deposits themselves are harmless, but may indicate the presence of in situ or invasive cancer.

Because there is no way to currently tell whether a DCIS lesion will turn into aggressive breast cancer, surgery and sometimes radiation, and/or hormonal therapy is the usual treatment course following diagnosis.

DCIS accounts for more than 80 percent of in situ carcinoma diagnoses, of which there were an estimated 60,290 in North America in 2015. The other 20 percent of cases were lobular carcinoma in situ (LCIS), which is normally not believed to be a precursor of invasive cancer.

Closing

BRIM technology identified 22 percent of samples had low ratios of cancer versus non-cancer biomarkers, suggesting those types of lesions were slow-growing and non-aggressive.

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