New test offers risk assessment for DCIS

A new risk assessment test is available for women diagnosed with Ductal Carcinoma in Situ (DCIS), that may assist with making treatment decisions. The test, known as DCISionRT®, looks at the likelihood of DCIS or invasive cancer recurring in the same breast after surgery, and the impact of radiotherapy in reducing that risk.

Last year, BCNA member Karyn was diagnosed with DCIS, considered to be a precancerous condition because the cells are contained within the milk ducts of the breast. DCIS has the potential to become invasive, which is why treatments can include surgery, radiotherapy and hormone-blocking therapy.

Karyn had surgery that nonetheless showed good clear margins. Her treatment team also advised she have radiotherapy.

‘I was really weighing up the pros and cons,’ says Karyn. ‘I kept thinking, my cancer is not invasive, so why do I need all this treatment?’

Karyn heard about DCISionRT®, which can help women who have been diagnosed with DCIS and had breast-conserving surgery, by assessing the benefit of having radiotherapy as well. The test uses a sample of breast tissue, already taken as part of a biopsy or breast surgery, which means women don’t need to have another procedure. The test can be done before or after breast-conserving surgery, with most women having the test after their surgery.

Karyn decided to have the test to get a more personalised risk assessment of the 10-year likelihood of DCIS recurring after surgery or progressing to local invasive breast cancer. The test would also indicate whether she was likely to benefit from radiotherapy.

The test studied the biology of her tissue. It assessed seven biomarkers, their interactions, and their relationship to four additional risk factors:

  • age at diagnosis
  • whether the lesion was found through mammography or a physical exam
  • extent or size of the lesion
  • whether the rim or margin of tissue surrounding the lesion was free of DCIS.

Karyn’s personalised report came back with a score of 0.8 out of 10. This indicated she was at very low risk of a recurrence or progression and meant that she could safely avoid having radiotherapy. For others whose tests reveal a higher risk of recurrence or progression, radiotherapy may be of benefit in addition to surgery.

‘The more personalised result showed my rate of recurrence would be the same with surgery alone or with radiotherapy as well. So, radiotherapy was considered to be of little to no benefit for me,’ says Karyn. ‘It was a huge relief.’

Women diagnosed with DCIS can access the test through leading radiation therapy provider, GenesisCare, who operate 38 centres across Australia. Your treating doctor can facilitate access to the test or alternatively you can contact GenesisCare directly. Cost is not a preclusion to accessing the test and it is available to both public and private patients. BCNA will continue to advocate for these types of tests to ensure equity and access.

For information about the test, including availability and costs, go to the DCISionRT® website, email, or phone 1300 086 870.

There is information about DCIS in My Journey.

Issue 88
Winter 2021