Mathilde Almekinders receives PALGA 2020 award for research on DCIS21-12-2020
PALGA is the national network and registry of pathology in the Netherlands: a registry containing reports from every pathology laboratory in the Netherlands since 1971. The PALGA award is awarded to the best abstract about research making use of data from this PALGA network.
Mathilde Almekinders’ research is part of the PRECISION (PREvent ductal Carcinoma In Situ Invasive Overtreatment Now) consortium led by Jelle Wesseling. Almekinders: “Overtreatment of ductal carcinoma in situ (DCIS) is a problem. Although DCIS is a potential cancer precursor, most women with DCIS will not develop breast cancer. Despite that, most women with DCIS will be treated with surgery, and often radiotherapy. We are looking for predictors that can distinguish between patients with a high risk of developing breast cancer, and women that have no elevated risk to help us prevent overtreatment.
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 were able to subsequently request tissue samples from 60 pathology laboratories within the Netherlands.
Almekinders researches factors in the tumor microenvironment in DCIS patients who have received only breast-conserving surgery as a treatment between 1989 and 2005. She discovered that DCIS patients with large fat cells in the breast tissue have an increased risk of developing breast cancer in the same breast, compared to DCIS patients with smaller fat cells. Patients with large fat cells in combination with high expression levels of the protein COX-2 in the DCIS cells have a 28,2% risk of developing breast cancer within 15 years. DCIS patients with smaller fat cells and lower expression levels of COX-2 have a low risk of developing breast cancer – one comparable to the general population of women.
In her award winning abstract, Almekinders revealed new findings based on multiplexed-immunofluorescence of immune cells in DCIS. The amount and composition of the immune cells does not predict which DCIS patients are at an increased risk of developing breast cancer, but it does correlate to specific characteristics of DCIS such as estrogen receptor and HER2 status.
In 2017, Professor 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 with harmless DCIS the burden of unnecessary treatment. In 2018, the PALGA Award was won by Lindy Visser, who was also working on DCIS as a PhD student in the Wesseling Group at the time.
The research project for which Almekinders received the PALGA award has been made possible through the financial support of Cancer Research UK, the Dutch Cancer Society, Pink Ribbon, and A Sisters Hope.