For decades, Ductal Carcinoma In Situ (DCIS) has been regarded as early breast cancer and therefore treated with surgery, often followed by radiotherapy. However, it has been known for a while that three out of four DCIS lesions never progress into invasive breast cancer. In line with current guidelines, almost all women with DCIS still undergo conventional aggressive treatment, as it is challenging to distinguish between the indolent, low-risk DCIS lesions from potentially progressive high-risk ones.
The Cancer Grand Challenges PRECISION consortium was the first international research team funded jointly by KWF Dutch Cancer Society and Cancer Research UK to identify harmless from potentially hazardous Ductal carcinoma in situ (DCIS). In the last seven years, the consortium, led by group leader Jelle Wesseling, has made impressive progress that also revolutionized the view on how women with DCIS as well as their health care providers frame a DCIS diagnosis, as they started to realize that DCIS is not early breast cancer. The LORD-trial, led by Wesseling as well, already tests whether leaving out treatment for low-risk DCIS is safe. So far, 60 per cent of all women with low-risk DCIS in the Netherlands participate in this trial of which up to 80 per cent opt for active surveillance and a better-preserved quality of life, as they do not have to carry the burden of possibly needless aggressive treatment.