Troy Bremer, Chief Scientific OfficerRadiation, however, isn’t a one-size-fits-all safeguard. Two women with tumors that look identical on paper can face very different outcomes—one might gain real protection against recurrence, while the other might endure side effects with little or no added benefit. And traditional tools couldn’t reliably distinguish between them.
PreludeDx™ created DCISionRT® to change that.
Instead of relying solely on how a tumor appears based on clinical and pathologic factors alone, the test integrates clinical and pathologic factors with the tumor’s underlying biology—the molecular signals that dictate its behavior. From this, it generates a Decision Score™ that provides two answers at once: a woman’s 10-year risk of recurrence, and the likelihood that radiation will significantly reduce that risk.
“Our test provides doctors the clarity to make a better and more informed treatment decision and patients the confidence that their treatment is the right one for them and not a one-size-fits-all approach,” says Troy Bremer, Chief Scientific Officer.
DCISionRT assesses seven key protein biomarkers within the tumor. These biomarkers act like fingerprints, revealing how fast the tumor grows, how sensitive it is to hormones, how well it repairs itself under stress, and how it regulates its cell cycle. The biological signals are combined with standard clinical data, such as age, tumor size and surgical margins, and then entered into PreludeDx’s proprietary algorithm. The algorithm then generates a score on a 10-point scale, where higher numbers indicate a higher recurrence risk and benefit from radiation therapy.
The Decision Score categorizes each patient into one of three categories—low, elevated and residual risk—with very different implications for risk and treatment.
Turning Low-Risk Diagnoses into Informed Choices
That was the case for a 37-year-old woman diagnosed with DCIS. On paper, she fit every definition of low risk: a 10-millimeter, intermediate-grade, non-palpable tumor that was hormone receptor positive with clear surgical margins. Her first instinct was a mastectomy to avoid radiation, a life-altering surgery at such a young age.
One decision can shape not just years of survival, but decades of quality of life.
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Our test provides doctors the clarity to make a better and more informed treatment decision and patients the confidence that their treatment is the right one for them and not a one-size-fits-all approach.
DCISionRT offered clarity. The test returned a score of 0.8, indicating no statistically significant difference in recurrence risk when treated with or without radiation. With that insight and shared decision-making with her clinician, she chose breast-conserving surgery without radiation. The decision avoided overtreatment; she maintained an excellent prognosis and, most importantly, it preserved her quality of life.
Guiding Smarter Choices, Preventing Overtreatment
Patients often assume more treatment means more safety. For a 69-year-old woman with DCIS, that belief pushed her toward a bilateral mastectomy, even though only one breast was affected. Her tumor was small, 6 mm, intermediate grade, estrogen receptor positive and progesterone receptor negative, with clear margins. Her doctor recommended a lumpectomy without radiation.
DCISionRT told a different story. Her score of 9.2 placed her in the Residual Risk subtype, where recurrence risk exceeds 40 percent with surgery alone and remains about 15 percent even after radiation. With that clarity, together with her physician, she chose a unilateral mastectomy with reconstruction, a decision that avoided overtreatment, addressed her elevated risk and preserved her well-being.
Safer Choices for Patients with Complex Health Needs
Some patients must weigh cancer treatment against other health concerns. That was the case with a 72-year-old woman with heart disease, who was diagnosed with DCIS on her left side, where radiation could increase cardiac risk. She leaned toward mastectomy, while her physician considered lumpectomy, depending on test results.
DCISionRT returned an elevated score, showing that radiation would meaningfully reduce her risk of recurrence. With that information, her physician recommended breast-conserving surgery with cardiac-sparing radiation. The patient agreed, choosing a plan that balanced cancer control with heart health.
On paper, all three women fit the same low-risk category, features that the National Comprehensive Cancer Network (NCCN) Breast Cancer Guidelines, based on trials such as Radiation Therapy Oncology Group (RTOG) 9804, have used to define treatment. In reality, their tumor biology told three very different stories. DCISionRT exposed the nuance that clinical pathology criteria could not, ensuring each patient’s treatment reflected her individual tumor biology and risk rather than a one-size-fits-all rule.
PreludeDx’s DCISionRT points to a future where treatment is not dictated by population averages but guided by precision—where every woman’s care plan reflects her unique risk, and where quality of life is preserved alongside cancer control.
Decision Clarity in DCIS Care
Breast cancer treatment planning has become more precise over the years, but ductal carcinoma in situ, or DCIS, still leaves many patients and clinicians facing difficult treatment decisions. The challenge is rarely a lack of clinical information. Physicians already have access to pathology reports, imaging and standard risk factors. The real issue is whether those details are specific enough to guide confident treatment choices when survival outcomes may remain similar, but quality of life, treatment burden and fear of recurrence can differ significantly from one patient to another.
In DCIS care, overtreatment and undertreatment both carry consequences. Some patients may undergo radiation therapy with limited benefit, while others may receive less treatment than their underlying biology actually warrants. This uncertainty adds difficulty to the treatment planning, as this is frequently not purely a medical decision. Patients are assessing the risks of the future, potential side effects, stress involved and peace of mind in the longer term.
A useful decision-support tool has to go beyond broad population statistics. Traditional clinical factors such as age, tumor grade, tumor size, surgical margins and hormone receptor status can help estimate recurrence patterns, but they do not always capture the biological differences that influence individual risk. Two patients with similar pathology results may still face very different outcomes.
More effective tools help physicians understand recurrence risk in a way that feels personalized rather than generalized. They should provide a clearer picture of likely recurrence after breast-conserving surgery alone and show how that risk changes if radiation therapy is added. They must also be able to provide understandable information on which to base open and honest communication between doctor and patient in an already stressful and emotionally taxing situation.
Balance also matters. A tool designed only to reduce treatment intensity may overlook patients who genuinely benefit from additional therapy. Tools that reinforce a radiation-all approach at every step of the way may counteract quality of life issues, which are particularly relevant in DCIS treatment. It offers the best way to define three clearly distinct patient groups: patients who might not need radiation, those who are predicted to benefit from radiation, and those at higher risk after standard therapy.
That distinction is valuable because DCIS treatment decisions often sit in a gray area between clinical guidelines, physician experience and patient preference. When risk discussions are vague, patients can end up feeling either falsely reassured or unnecessarily frightened.
Clinical usability is another major factor. Decision support becomes valuable if it is incorporated into the doctor-patient dialogue and not the motivation to reject professional knowledge. Clinicians need results they can explain clearly, supported by validation data and practical language that helps patients understand why similar diagnoses can still lead to different treatment recommendations.
For hospitals, oncology groups and specialized breast programs, that clarity can improve consistency in care while still preserving individualized treatment planning. PreludeDx stands out in this area because its DCISionRT test was designed specifically to support treatment decisions for patients with DCIS. The test provides individualized recurrence risk estimates after breast-conserving surgery alone and after radiation therapy, while also helping assess the likely benefit of radiation treatment.
By combining molecular pathway data with traditional clinical and pathology factors, the test produces a Decision Score that helps distinguish lower-risk, elevated-risk and residual-risk patient profiles. That approach aligns closely with what physicians and patients often need most: clearer information that supports more confident and balanced treatment decisions.
For a precision care-driven organization that supports a patient-centered approach to treatment planning and educated decisions about radiation therapy, PreludeDx provides a clinically practical and evidence-based method for DCIS management.
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Breast Cancer Decision-Making Tools Info
Q1
What distinguishes PreludeDx among Top Breast Cancer Decision-Making Tools providers?
PreludeDx has earned recognition among Top Breast Cancer Decision-Making Tools providers through its precision diagnostic platform designed to personalize treatment decisions for women diagnosed with early-stage breast cancer, particularly ductal carcinoma in situ (DCIS). Its flagship test, DCISionRT®, integrates tumor biology with clinical and pathological data to generate a Decision Score that helps physicians and patients evaluate recurrence risk and potential benefit from radiation therapy. Unlike traditional approaches that rely mainly on tumor size or grade, the company focuses on biological behavior to guide treatment decisions more accurately.
Q2
How does PreludeDx’s DCISionRT® support clinical decision-making?
Biology-driven risk assessment sits at the center of the company’s approach to Breast Cancer Decision-Making Tools. DCISionRT® evaluates protein biomarkers within the tumor and combines them with clinical factors to calculate an individualized risk score. This score estimates both the likelihood of cancer recurrence and the potential benefit of radiation therapy after surgery. By translating complex tumor biology into a clear decision framework, the tool helps clinicians tailor treatment intensity rather than applying a uniform approach to all patients.
Q3
Why is PreludeDx relevant to modern breast cancer treatment strategies?
Breast cancer care is increasingly shifting toward personalization, where treatment is based on individual tumor biology rather than generalized risk categories. PreludeDx addresses this shift through Breast Cancer Decision-Making Tools that support shared decision-making between patients and physicians. Its platform helps reduce overtreatment in low-risk cases while identifying patients who may benefit from additional therapy. This balance between treatment effectiveness and quality of life has made biological decision-support tools more relevant in modern oncology practice.
Q4
What role does tumor biology play in PreludeDx’s testing approach?
Tumor biology is the foundation of how PreludeDx structures its diagnostic model. The DCISionRT® test evaluates multiple biomarkers associated with tumor growth, hormone sensitivity and cellular repair mechanisms. These biological signals are combined with clinical data to generate a more complete risk profile than traditional pathology alone can provide. Within Breast Cancer Decision-Making Tools, this biological integration allows physicians to better understand how an individual tumor may behave over time rather than relying solely on static diagnostic categories.
Q5
How does PreludeDx support patients and physicians during treatment planning?
Shared decision-making is central to the company’s clinical philosophy. PreludeDx provides structured reporting that translates test results into actionable insights, helping physicians explain treatment options more clearly to patients. This includes understanding recurrence risk, evaluating radiation benefit and considering long-term quality-of-life outcomes. By offering clearer biological context, Breast Cancer Decision-Making Tools from PreludeDx help reduce uncertainty and support more confident treatment choices between surgery alone or combined therapy approaches.
Q6
Why has PreludeDx gained recognition in precision oncology?
PreludeDx has gained recognition due to its consistent focus on biologically informed decision support in early-stage breast cancer care. Its DCISionRT® platform has been validated across multiple clinical studies and is used to help refine radiation therapy decisions in thousands of patients. The company’s emphasis on integrating molecular biology with clinical decision-making reflects a broader shift in oncology toward precision medicine. This combination of validated science, clinical usability and patient-centered design reinforces its standing in Breast Cancer Decision-Making Tools.
