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Blood Test May Reduce Aggressive Breast Cancer Treatments for DCIS Patients
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New research from the University of Michigan and the University of Kansas suggests that doctors may be able to personalize breast cancer treatment for patients diagnosed with ductal carcinoma in situ (DCIS), potentially avoiding unnecessarily aggressive interventions. A novel blood test, utilizing a microfluidic “labyrinth chip,” can detect circulating cancer cells, offering a potential biomarker to predict disease progression and guide treatment decisions.
Understanding Ductal Carcinoma In Situ (DCIS)
Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer, meaning the cancer cells are confined to the milk ducts and haven’t spread to other parts of the breast or body.Approximately 25% of the 2.3 million women diagnosed with breast cancer today receive a DCIS diagnosis. While generally considered highly treatable, DCIS carries a risk of becoming invasive cancer – estimated between 10% and 53% if left untreated. This uncertainty drives current treatment recommendations.
Current Treatment Approaches
Due to the potential for progression, current clinical guidelines typically reccommend treatment for all DCIS patients. Common treatments include:
- Lumpectomy: surgical removal of the tumor and a surrounding margin of healthy tissue.
- Mastectomy: Surgical removal of the entire breast.
- Radiation Therapy: Often recommended after lumpectomy to kill any remaining cancer cells.
- Anti-hormonal Therapy: Prescribed for hormone receptor-positive DCIS to block the effects of estrogen and prevent cancer growth.
The challenge lies in determining which patients truly *need* these aggressive treatments and which could be safely monitored or treated with less intensive approaches.
The Promise of a Blood-Based Biomarker
The research team, led by sunitha Nagrath at the University of Michigan and Fariba Behbod at the University of Kansas Medical Center, aimed to identify biomarkers that could predict DCIS progression. Their focus was on detecting circulating tumor cells (CTCs) – cancer cells that have shed from the primary tumor and are circulating in the bloodstream.
“Currently, patients are frequently enough presented with treatment options without adequate information regarding which choice might potentially be most effective based on their individual risk factors,” explains Sunitha Nagrath, Dwight F. Benton Professor of chemical Engineering at the University of Michigan.
The “Labyrinth Chip” Technology
Detecting CTCs is notoriously difficult, as they are present in very low concentrations in the blood. to overcome this challenge, the researchers utilized a microfluidic device called a “labyrinth chip.” Developed in 2017 by Nagrath and Max Wicha, this chip works by:
- Separating Cells by Size: A blood sample is passed through a maze-like network of channels.
- Isolating Cancer Cells: The channels are designed to trap larger cancer cells and white blood cells,
