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Dr. Charles Loewe: Case 3
Downstaging a female patient with elevated clinical risk
This is the case of a 60-year-old female patient with long-segment non-dysplastic Barrett’s esophagus and a complicated medical history including a tumor of the rectum. Dr. Loewe utilized a low-risk TissueCypher score to downstaging care.
“Now we have the ability with TissueCypher to allay the patient’s anxiety and reassure the physician that he is doing the right thing for the right patient.”
Clinical risk factors
60-year-old, white female
A 60-year-old female patient with a complicated clinical history including Hashimoto’s disease, a tumor of the rectum, breast cancer, and a family history of lung and colon cancer.
Endoscopic findings
The endoscopy confirmed the persistence of long-segment non-dysplastic Barrett’s esophagus.
Lower esophagus:
- BE segment: C7M9
- 1.5 cm hiatal hernia
- Non-dysplastic pathology
- Concurrent acute and chronic reflux esophagitis with reactive epithelial atypia
Traditional Management:
- Clinical profile: High risk
- Treatment recommendation: 3-year surveillance
From top left to top right: Barrett's esophagus, EGJ
TissueCypher results
Dr. Loewe leveraged a low-risk TissueCypher score and share decision making to extend the surveillance interval from 3 to 5 years for this patient.
- Risk class: Low
- Risk score: 3.4
- 5-year risk of progression: 2%
TissueCypher-guided management
- Change in management: Downstaged
“Now we have the ability with TissueCypher to allay the patient's anxiety and reassure the physician that he is doing the right thing for the right patient.”
Charles Loewe, MD