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10Feb 2017

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Over 17 million Euros in grants for research into precancerous breast cancer

Wesseling, Pathologie Antoni van Leeuwenhoek (AVL).

Women with a precancerous stage of breast cancer, DCIS [Ductal carcinoma in situ], are now all treated as if they have cancer. Pathologist Jelle Wesseling from the Netherlands Cancer Institute has received a multimillion Euro grant and award from Cancer Research UK and KWF [Dutch Cancer Society] (Grand Challenge) to change this. Because: often DCIS does no harm and therefore thousands of women all over the world are undergoing unnecessarily severe treatments.

The British sister organization of the Dutch Cancer Society, Cancer Research UK, has launched a major project to "tackle, globally, key challenges in today's cancer research." Researchers who came up with the best plan, could qualify for a Grand Challenge of many millions of pounds to tackle these problems. Jelle Wesseling from the Netherlands Cancer Institute is the leader of one of the four winning teams. He receives no less than 15 million pounds - nearly 17.5 million Euros - to solve the problem affiliated with DCIS. Half of this money comes from CRUK, the other half from the Dutch Cancer Society.

Thousands women have

 DCIS, full ductal carcinoma in situ, a precancerous stage of breast cancer. In the Netherlands alone, this condition is diagnosed in several thousand women each year. In DCIS, there are abnormal cells in the milk ducts in the breast. On scans, this can be seen as calcium specks. Wesseling: "These abnormal cells may become cancer if they grow from the milk ducts into the breast tissue. But we now know that this often does not happen. Sometimes, the abnormal cells grow very slowly. Moreover, DCIS cannot metastasize. Therefore, in many cases, DCIS is actually harmless. The big problem is: at present, we cannot distinguish between the women with DCIS who will develop cancer, and those who will not. That is what in my research is about: determining the distinction between high-risk and low-risk DCIS, and thus, saving so many women from an unnecessary, burdensome treatment."


Drastic treatments

Since it can not be predicted at this time which women are at risk of having their DCIS develop into cancer, all women are now treated as if they have it. "This treatment is pretty drastic," says Wesseling. "Women with DCIS now all receive surgery. And when it is a lumpectomy, then radiation usually follows, as well. In fact, these women are treated as if they have breast cancer. While that is regularly not even necessary. We estimate, based on the research that has been done so far, that DCIS will never develop into cancer in 30 to 50 percent of cases."

The latter is a rough estimate. But it would mean that, at present in Netherlands alone, hundreds of women are being over-treated every year. Globally, this number is much higher. In the US, for example, about 60,000 women a year are diagnosed with DCIS. Thus, probably tens of thousands of women receive unnecessary treatment. "My challenge here to change that," says Wesseling. "It is important for women who need to be treated, to receive the treatment they need. But also, for the women who do not, it is important to save them from the physical and psychological burden of this treatment."

Thanks to the Grand Challenge, Wesseling can now get to work as the head of an international research team. The project will run for five years.

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