How do I know if my DCIS breast cancer will become invasive?

With all the genomic work that’s being done, we’re looking for ways to distinguish ductal carcinoma in situ (DCIS) cases that will be significant clinically versus those that will not, because many of them will not. It’s a very slow to develop tumor, but some forms of DCIS are more aggressive and will transform into invasive cancers. We can’t design a good clinical trial for DCIS. If you think about it, it wouldn't be ethical because you really can’t tell which patients are going to do okay and which ones aren’t. You can’t take 1,000 patients with a diagnosis of DCIS and watch 500, while the other 500 have a definitive removal of their DCIS.