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Certain Factors Help Predict Invasive Breast Cancer

A recent study published in the Journal of the National Cancer Institute suggests that 2 factors can help predict the risk of developing future invasive cancer in women with noninvasive breast cancer. This could help women and their doctors make more informed treatment choices. The 2 factors identified in the study were: 

  • Whether the ductal carcinoma in situ (DCIS) was detected as a lump or by mammography

  • Which combinations of biomarkers were present on the DCIS tissue  

Understanding DCIS

DCIS refers to cancer in the breast's milk ducts that has not spread. It is the most common type of noninvasive breast cancer, accounting for about 1 out of every 5 new breast cancer cases in the U.S. DCIS is not deadly, but it raises your risk for future invasive cancer.

Some women with DCIS are treated with lumpectomy alone. In a lumpectomy, the tumor and surrounding tissue are removed. Studies have shown that 5% to 10% of women with DCIS treated by lumpectomy alone develop an invasive form of breast cancer within 5 years. But research trying to identify which of these women are at higher risk has had mixed results.

Method of cancer detection and biomarkers predict risk

To determine risk factors for invasive cancer in women with DCIS, researchers interviewed 1,162 Californian women who had been diagnosed with DCIS and underwent lumpectomy for treatment.

Women whose original DCIS was found when a lump was felt by their doctors were more likely to develop a subsequent invasive cancer as women whose DCIS was found by mammography.

In addition, analysis of DCIS tissue found that several biomarkers predicted risk for developing invasive breast cancer. A biomarker is a substance that is produced by the body and indicates a specific process, condition, or disease. Risk was higher in women with DCIS positive for 3 biomarkers: p16, cyclooxygenase-2, and Ki67.

The study authors think that this information will help doctors to better predict the risk level of developing invasive cancer later for women who are treated with lumpectomy. Those who are at high risk may be better candidates for additional treatment.

Tests that profile the "molecular signature" of breast cancer tissue can be used to predict risk of recurrence and response to treatment.  

Lowering your risk after breast cancer

All forms of breast cancer raise your risk for new cancer. But there are ways to help lower your risk. Talk with your doctor about these tips:

  • Maintain a healthy weight. Being overweight can boost your risk for breast cancer coming back or a new cancer forming.

  • Get active. Research suggests that regular exercise can help lower your risk for a new breast cancer or the original cancer returning.

  • Consider preventive medicines. Ask your doctor if you might be a good candidate for preventive medicines, such as aromatase inhibitors and selective estrogen receptor modulators, which lower the risk for recurrence of certain breast cancers or for new cancers developing.

  • Avoid hormone replacement therapy. Most experts agree that the higher risk for a subsequent cancer outweighs the benefits of hormone replacement therapy in women who have had breast cancer. 

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