CRUK Precision

  • Research type

    Research Study

  • Full title

    Physico-Chemical analysis of ductal carcinoma in-situ (DCIS) breast calcifications using infrared, Raman and X-ray diffraction - for diagnosis of malignancy and prediction of progression.

  • IRAS ID

    237736

  • Contact name

    Nick Stone

  • Contact email

    n.stone@exeter.ac.uk

  • Sponsor organisation

    University of Exeter

  • Duration of Study in the UK

    4 years, 6 months, 30 days

  • Research summary

    Ductal carcinoma in situ (DCIS) represents 20-25% of all breast neoplasia. This is due to large-scale detection by widely adopted population-based breast cancer screening programmes. As a result, thousands of women are confronted with DCIS each year. Conventional management includes surgery, supplemented by radiotherapy and/or endocrine therapy, but tends to overtreat the majority of DCIS; as ~1% recur annually and breast cancer mortality is ~3% at 20 years. Uncertainty as to which DCIS lesions will progress to invasive cancer or, after excision, which will return with recurrent DCIS or invasive breast cancer drives this overtreatment. Distinguishing DCIS that may progress to lethal disease from the majority of harmless DCIS is therefore an urgent need to save thousands of women with low risk DCIS the burden of radical treatment without any survival benefit.

    CRUK-Precision aims to reduce the burden of overtreatment of DCIS through the development of novel tests that promote informed and shared decision-making between patients and clinicians, without compromising the excellent outcomes for DCIS management presently achieved.

    In breast mammography, the majority of DCIS are present with calcifications that are the depositions of calcium oxalate (type I) and carbonated calcium hydroxyapatite (type II), and are diagnostically significant radiological features.

    While the type I calcifications are mainly associated with benign cases, the type II are the most frequently observed calcifications and can be found in both benign and malignant lesions, although they are mostly found to be associated with malignancy.

    As part of work package 4, imaging based on infrared, Raman and x-ray diffraction will be carried out to study the physico-chemical features of breast calcifications and the surrounding soft tissue to identify biomarkers for refining DCIS prognosis and outcome.

    The findings will be linked to the genetic and immunological information generated by other work packages in CRUK-Precision.

  • REC name

    London - Harrow Research Ethics Committee

  • REC reference

    18/LO/0945

  • Date of REC Opinion

    24 May 2018

  • REC opinion

    Favourable Opinion