The past five months have been an amazing time for the Foundation. Not only have we given out $100,000 in pilot grants to support 12 exciting research studies, but we’ve also received grant awards that will allow us to advance our own research endeavors.
I had the opportunity to tell you about two of the grants we recently received in our July e-newsletter. This month, I’m pleased to tell you about a new $850,000 grant we just received from the California Breast Cancer Research Program (CBCRP). (CBCRP, which gives grants solely to researchers in California, is an incredible program. Its grants are funded by California state tobacco taxes. In addition, Californians can donate to the fund by checking off a box on their income tax return.)
As you know, I’m always excited when the Foundation receives a new grant award. But I’m especially excited about this grant because it will allow us to take the next step in studying whether we can treat or prevent breast cancer by putting chemotherapy down the milk ducts.
As many of you know by now, virtually all breast cancer begins in the lining of the milk ducts. Ductal carcinoma in situ (DCIS), which we think of as a precancer, is one of the first steps in this process. When a woman has DCIS, her milk duct is filled with cells that look like cancer cellsâ€”but they are contained within this one duct. (As long as the cells are inside this duct, they canâ€™t spread to other parts of the body.) Eventually, 30-40 percent of women with DCIS will go to develop invasive cancer. In these women, the cancer cells are able to gain the strength they need to break out of the duct and invade other areas. In the other 60-70 percent, the cells will never go on to become invasive, and will remain inside the duct.
Unfortunately, we currently have no way to identify which DCIS will progress and which will not. As a result, we treat all cases of DCIS aggressively. Furthermore, we treat it the same way we treat invasive breast cancerâ€”with surgery, radiation, and hormone therapy. And as more and more women have come to be diagnosed with DCIS through mammography screening, concerns about these extreme treatment measures have grown. (Before mammography, we rarely had anything called DCIS, because it doesn’t usually form a lump).
We have lots of data now from studies done on rats and mice that show that putting a low dose of chemotherapy through the nipple into the milk ducts can prevent breast cancer from developing. I like to think of it as acting like Drano, cleaning out the clogged pipes! Our newly funded study will capitalize on the fact that we now can access the ducts in women with a toolâ€”a ductal catheter. This is the same tool that we use to perform ductal lavage, which we use to remove fluid from the duct.
Our hypothesis is that we can treat DCIS by putting the chemotherapy drug pegylated liposomal doxorubicin (PLD), also known as Doxil, directly into the duct that has the DCIS. Studies done in rats have shown that this approach has no side effects. Our study called “Effect of Intraductal Therapy of DCIS with Pegylated Liposomal Doxorubicin (PLD) on Pathology and Biomarkers: A Presurgery Study,” will enroll 30 women who have been diagnosed with DCIS. The study will begin with us identifying which duct contains the DCIS. Second, we will perform an MRI and ductal lavage so that we can document the DCIS. Lastly, we will do one or two intraductal instillations of PLD into the affected duct. Our volunteer will go home, with a surgery date set in four to six weeks. A day or two before the surgery, she will have another MRI , so that we can see what the DCIS now looks like. Then, right before the surgery, we’ll lavage the volunteer’s duct again, so that we can see what the ductal cells look like after having been treated with PLD.
Another exciting aspect of this project is that Iâ€™m working both with my close colleague, Ellen Mahoney, MD, and a wonderful advocacy organization in Northern California, the Humboldt County Community Breast Health Project. We are all incredibly enthusiastic about the potential this project has to lead to a new less invasive way to treat DCIS, and we canâ€™t wait to start recruiting women with DCIS from Humboldt County this fall.
I’ve thought about trying to do a research study like this for a long time. To see it actually happening is a sign of how far the intraductal research field has come over the past five years. None of this would have occurred without the generous support we have received from women and men throughout the world who believe in the Foundation and its mission: to eradicate breast cancer within our lifetime. Please join us!