New breast cancer treatment trial at UCSF aims to avoid invasive surgery for patients
By Elizabeth Cook
Waiting and seeing is not often the strategy employed when it comes to treating breast cancer, but a new clinical trial by the University of California, San Francisco, researchers are doing just that.
The goal of this clinical trial, led by UCSF researcher Dr. Laura Esserman, is to help patients avoid debilitating treatments like surgery through “watchful waiting.”
This trial focuses on a specific type of breast cancer known as Ductal Carcinoma In Situ (DCIS).
“DCIS itself is not life-threatening. It’s a window of opportunity to figure out how to prevent you from getting invasive cancer,” said Esserman.
DCIS develops in the milk ducts of the breast and is often called “Stage 0” breast cancer.
According to the National Breast Cancer Foundation, 20-25% of all breast cancers are considered DCIS.
But despite its non-invasive nature, the standard treatment is often aggressive surgery to completely remove the breast tissue.
“It’s no picnic to get a mastectomy, and it’s certainly no picnic to have a bilateral mastectomy,” explains Esserman. “That’s the way we always used to do it, and you don’t know any better. but what if you don’tneed it?”
Judy Li learned she had DCIS 10 years agoand began looking for alternative options after learning about possible treatments.
“About 90% of women had a mastectomy or hysterectomy. They had treatment, they had surgery,and those were the statistics I was looking at. And they were pretty scary,” said Li.
That’s when Li found Esserman’s RECAST Trial.
Instead of immediately turning to invasive procedures like surgery, the UCSF researchers monitor the cancer on a regular basis while trying out various other non-invasive forms of treatment, such as hormone therapy.
“Everyone has the opportunity to find out how they respond, and at six months they can make a decision about what they want based on what the therapy is,” Esserman explained.
The waiting has been hard at times for Li, who gets re-screened every six months before she knows if there is good news or bad news.
“I remember thinking gosh this is not for the faint of heart… I can now appreciate the current standard if you will, of just basically getting it cut out because that 100% at that moment, that certainty,” said Li.
But 10 years after her initial diagnosis, Li has avoided any major surgery.
UCSF hopes that studying DCIS at the earliest stages will lead to better outcomes for women with all stages of breast cancer.
“Clinical trials are tomorrow’s treatments today. Not everything will work, that’s why you have to test it,” explains Dr. Esserman. “But everything that is good and better has been done because we’ve done a trial and tried something new.”
For more information about the RECAST clinical trial:
