When Alexia Vernon, a Las Vegas-based professional speaker and CEO of the communication and leadership development company, Step into Your Moxie, received a ductal carcinoma in situ (DCIS) diagnosis in November 2024, she faced a period of complex decision-making about treatment options. Having already survived thyroid cancer, she was particularly focused on avoiding over-treatment while ensuring the best possible outcome.
“During my thyroid cancer journey — my first serious diagnosis — I learned how important it is to clarify your health values and goals for your treatment,” Alexia says.
Each year, more than 50,000 women are diagnosed with DCIS, a non-invasive type of breast cancer. While DCIS can’t spread beyond the breast, treatment is necessary as some DCIS cells could develop into invasive breast cancer.
Usually, women with DCIS are treated with breast-conserving surgery (BCS), also known as lumpectomy. Patients then must decide whether or not to get radiation therapy (RT). Traditionally, this decision is guided by the patient’s doctor, who makes a recommendation based on clinical factors such as age, tumor grade, tumor size and margin status.
But in more recent years, major scientific studies have proven that relying on these clinical factors alone has failed to identify patients who could safely omit RT after BCS. While RT can effectively reduce the risk of recurrence for some women, others with low-risk DCIS may not derive significant benefits from the therapy and may be exposed to unnecessary radiation and its associated side effects. Conversely, omitting RT in women with higher-risk DCIS could lead to under-treatment and an increased risk of recurrence.
For Alexia, imaging revealed architectural distortion in her left breast, but after multiple procedures and an initial diagnosis of atypical ductal hyperplasia (ADH), further surgery revealed low-grade DCIS. The diagnosis came at an already challenging time, as she was also healing from vocal cord surgery.
While researching treatment options online, Alexia found herself overwhelmed by stories of aggressive interventions.
“During my journey, it was tricky to find anybody sharing a story like mine,” Alexia says. “Almost every DCIS narrative I read included a bilateral mastectomy, radiation and/or endocrine therapy. Almost nobody’s treatment plan was just surgery. I yearned for examples of a middle path.”
The turning point in Alexia’s treatment journey came with the DCISionRT test — the only risk assessment test for patients with DCIS that predicts radiation therapy benefit.
“When I first learned I had DCIS, I was overwhelmed by the possibility of needing to take more time off from running my business, and I worried that if radiation were warranted, it might damage my already fragile vocal cords,” Alexia shared. “My DCISionRT results showed me that my treatment could be complete after surgery. I felt like I won the lottery!”
Alexia’s results showed she had only a 3-5% chance of DCIS or invasive breast cancer recurrence over 10 years with breast-conserving surgery alone. This meant no radiation, no endocrine therapy, and no mastectomy.
By analyzing the individual biology of a woman’s tumor, DCISionRT helps doctors and patients make more informed treatment decisions. For women identified as low-risk like Alexia, the test can provide reassurance about forgoing more aggressive treatments while maintaining a high probability of a cancer-free future.
“I feel confident knowing my recurrence risk is very low,” Alexia says. “The results of this test saved me from what could have been over-treatment of my DCIS. I can move forward with my life and continue my work while maintaining appropriate monitoring.”
Building on her existing work with healthcare and life sciences organizations, Alexia is expanding Step into Your Moxie’s services by incorporating narrative medicine and patient-centered communication into training programs to help clinicians navigate high-stakes conversations and deepen trust with patients.
“I had an amazing oncological surgeon, Dr. Janie Grumley, at Providence’s Margie Petersen Breast Center, who automatically sent my pathology from an excisional biopsy to PreludeDx. Too many people I connected with on my journey were not so lucky. I want to ensure other people diagnosed with DCIS can also find the sweet spot between over- and under-treatment,” Alexia says. “Tools like DCISionRT help make that possible.”
