Studies Completed by the VBCSS

The Vermont PROSPR Research Center (VPRC)

This study was comprised of two supporting cores and three research projects. The Vermont Breast Cancer Surveillance System (VBCSS) collected breast imaging and pathology data from all Vermont breast imaging facilities, as well as the Vermont and New Hampshire cancer registries. The overarching theme of the research projects was "Reducing overtreatment due to screening: Identifying predictive markers of ductal carcinoma in situ (DCIS) progression.” One of the harms of the breast cancer screening process is the diagnosis of DCIS cases that would never impact a woman’s life expectancy. We identified novel markers that stratified DCIS patients by risk of progression to invasive disease and can be used in the development of personalized treatment strategies. Our research used VBCSS data and biospecimens for about 1,400 women diagnosed with DCIS. The research team came from several institutions, covering a broad range of disciplines including: population science, epidemiology, statistics, pathology, molecular pathology, health services research, radiology, oncology. surgery and behavioral science.

Dr. Donald Weaver, a preeminent pathologist at the University of Vermont Medical Center led project 1, where he developed a new grade classification system as a surrogate for molecular markers that has been adopted in clinical practice. Dr. Brian Sprague, a population scientist and director of the VBCSS led project 2 which examined breast density and collagen alignment as predictors of the progression of DCIS. The third project was led by Dr. Amy Trenthan-Dietz at the University of Wisconsin. She is a member of the NCI supported Cancer Intervention and Surveillance Modeling Network (CISNET) and modeled the comparative effectiveness of incorporating DCIS prognostic markers into the breast cancer screening process for personalized management strategies.

Please click here to access publications associated with this study.

This study was funded by grant U54 CA163303 from the National Cancer Institute (NCI).

Different Forms of DCISImages created by sarahkayb, used in accordance with Creative Commons and the Attribution-Share Alike 4.0 international license. The images have not been altered.

Molecular and Cellular Characterization of Screen-Detected Lesions

The VBCSS partnered with collaborators in multiple UVM Departments to study the molecular characterization of screen-detected breast cancer, including DCIS, as part of the National Cancer Institute's Consortium for Molecular and Cellular Characterization of Screen-Detected Lesions.  We assembled a multi-disciplinary research team to address this problem, including experts in the basic, clinical, and population sciences. Our ultimate goal was to develop prognostic markers that would enable personalized management strategies for DCIS, such that the benefits of early detection are realized while eliminating unnecessary treatment and side effects.

We focused on the following research questions:
Are there molecular profiles identified in symptom-detected breast cancers that can discriminate indolent vs. aggressive screen-detected breast cancers?
Can we identify aspects of the DCIS tumor microenvironment that are predictive of recurrence?

Important Collaborators in this work include:
The Stein/Lian laboratory in the UVM Department of Biochemistry
The UVM Departments of Pathology and Radiology
The UVM Experimental Pathology Laboratory
The Consortium for Molecular and Cellular Characterization of Screen-Detected Lesions

Please click here to access publications associated with this study.

This study was funded by grant U01 CA196383 from the National Cancer Institute (NCI).