Sometimes it is not the cancer cell that is the problem: new insights into DCISI attended the American Association for Cancer Research Annual Meeting in Denver to spread the word among scientists about the Love/Avon Army of Women. While there, I attended a number of interesting sessions on different aspects of cancer. One that was especially great was the Symposium on ductal carcinoma in situ (DCIS), which was moderated by my old friend Dr. Stuart Schnitt, a pathologist at Deaconess Beth Israel Hospital, in Boston.
Dr. Monica Morrow, a breast cancer surgeon, at Memorial Sloan-Kettering Cancer Center, in New York, started us off with a comprehensive summary of the state of current treatment options for DCIS. We then heard two great talks about new research into what leads DCIS to transition into invasive cancer.
We have always thought that breast cancer started in the lining of the milk ducts as extra cells, then slowly progressed to atypical hyperplasia, then to DCIS, and then to invasive cancer. But the most recent studies suggest that it is not one sided. It now looks like it is probably NOT that the DCIS cells develop the ability to invade outside the duct but rather that it is the surrounding cells that allow and maybe even instigate this invasive behavior.
Anyone who has heard me talk about breast cancer in the past ten years knows that I strongly hold to the idea that cancer is a problem of both the mutated cells and the local and systemic environment in which they live. This new understanding supports this.It seems that the fibroblasts (cells that give rise to connective tissue), which live in the area around the breast ducts, allow and in fact stimulate the mutated cells to invade and head to the blood vessels and the rest of the body. The myoepithelial cells that surround the duct lining are the barrier between the abnormal lining cells and the stimulating fibroblasts that live in the surrounding area. When they break down, invasion occurs.How and when this happens is a topic of feverish research that may hold the key to preventing invasive breast cancer.