The subject of Lindy Visser's research is DCIS, ductal carcinoma in situ, a potential precursor of breast cancer. Visser says: "We currently do not know which women will develop breast cancer and which ones will not. As a result, all women with DCIS are currently treated to prevent the development of breast cancer. This treatment consists of surgery and is often followed by radiotherapy. However, many of these women are treated needlessly. Yet, we are unable to identify the women who can safely skip this intensive treatment. Therefore, we aim to find predictors that can help us distinguish between women with a high risk of developing breast cancer and women that have no elevated risk of developing this disease."
Recently, Visser found that the proteins HER2 and COX-2 together are a good indicator of breast cancer risk. Patients treated with breast conserving surgery alone have a 23 per cent chance of developing breast cancer within 15 years when their DCIS lesions had high amounts of HER2 and COX-2. However, if COX-2 was present in low amounts, the chance of developing breast cancer was comparable to the risk of women that were never diagnosed with DCIS. She published these findings in the scientific journal Clinical Cancer Research on June 12th.
In her award-winning abstract, Visser also revealed some new findings based on RNA analysis: "We have found that DCIS cells with certain gene expression profiles send signals to the immune system. We do not know yet whether these signals stimulate the immune system to prevent cancer or function for the benefit of cancer development."
Using data from the Netherlands Cancer Registry, the researchers working on this DCIS project have set up a cohort including all women diagnosed with DCIS from 1989 onwards, including treatment information. With the help of PALGA they could subsequently request the tissue samples from 60 pathology laboratories within the Netherlands. The research project for which Visser received the PALGA-price is financed by Pink Ribbon and A Sister's Hope.
In 2017, Wesseling was granted the Grand Challenge Award funded by Cancer Research UK and the Dutch Cancer Society for his research on DCIS. With this, a global initiative was set-up to learn how to distinguish harmless from potentially hazardous DCIS. This may ultimately save many women the burden of unnecessary treatment for harmless DCIS.