Dr Hendrika Duivenvoorden
What is the project?
Due to mammographic screening there has been an increase in the diagnosis of very early stages of breast cancer, ductal carcinoma in situ (DCIS), where abnormal cells have not yet broken out of the milk ducts and can usually be removed by surgery. However, it is difficult to predict the rate that patients diagnosed with DCIS will go on to develop invasive cancer, making decisions about further therapy difficult. We have found that the presence of a little protein, called ‘stefin A’ in the milk duct barrier might protect against cancer invasion and help us to determine the risk of cancer cell escape. During this one-year project, we will be looking closely at DCIS tissue from patients that have been followed over time, to uncover if the amounts of stefin A can predict breast cancer coming back. We hope that this will lead to a ‘stefin A test’ being developed.
What is the need?
In Australia, 1 in 8 women will be diagnosed with breast cancer before the age of 85 and approximately 15-25% of breast cancers diagnosed by mammograms are at the early cancer stage, DCIS. Unfortunately, there are no current methods for doctors to determine which of these early cancers will progress to invasive disease later on in life. Therefore, many women diagnosed with DCIS receive surgery, along with radiotherapy, chemotherapy and/or hormone therapy.
What are you trying to achieve?
We hope that by looking for stefin A in the biopsy of the patient (a procedure already performed at diagnosis) we can help stratify patients into those at low risk of breast cancer progression that may not need further therapeutic intervention, or those at high risk that may benefit from radiotherapy or chemotherapy. Ultimately, it is our goal to provide a standardised test that can be used by clinicians to individualise patient care in a type of cancer where individualised approaches are difficult. The thought of breast cancer coming back one day is scary, and if we can predict if that is going to happen, we can save a lot of worry and potentially prevent some women from receiving additional therapy that they may not benefit from.
Cancer Council Postdoctoral Fellowship