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Marc Daniel Ryser

Adjunct Professor in the Department of Population Health Sciences
Population Health Sciences
Box 90320, Durham, NC 27708
215 Morris St, Suite 210, Durham, NC 27701

Selected Publications


Mapping the temporal landscape of breast cancer using epigenetic entropy.

Journal Article Commun Biol · October 16, 2025 Although generally unknown, the age of a newly diagnosed tumor encodes valuable etiologic and prognostic information. Here, we estimate the age of breast cancers, defined as the time from the start of growth to detection, using a measure of epigenetic entr ... Full text Link to item Cite

Imaging Changes and Outcomes of Patients Undergoing Active Monitoring for Ductal Carcinoma In Situ: Seven-Year Follow-up Study.

Journal Article Acad Radiol · July 2024 RATIONALE AND OBJECTIVES: To determine the imaging changes and their associated positive predictive value (PPV) for invasive breast cancer in women undergoing active monitoring for ductal carcinoma in situ (DCIS). MATERIALS AND METHODS: In this seven-year ... Full text Link to item Cite

Abstract A038: Evaluating DCIS progression: A comparative analysis of CNA predictive power derived from lpWGS and WES data

Conference Cancer Research · February 1, 2024 AbstractDuctal carcinoma in situ (DCIS) is a very common non-life threatening, pre-invasive form of breast cancer constituting 25% of all new breast cancer diagnoses in the USA, and is normally treated with ... Full text Cite

A Residual-Attention Multimodal Fusion Network (ResAMF-Net) for Detection and Classification of Breast Cancer

Conference Progress in Biomedical Optics and Imaging Proceedings of SPIE · January 1, 2024 Digital breast tomosynthesis (DBT), synthetic mammography, and full-field digital mammography (FFDM) are commonly used medical imaging modalities for breast cancer screening. Due to the data complexity, most CAD research applies to only one modality, which ... Full text Cite

Association of DCIS size and margin status with risk of developing breast cancer post-treatment: multinational, pooled cohort study.

Journal Article BMJ · October 30, 2023 OBJECTIVE: To examine the association between size and margin status of ductal carcinoma in situ (DCIS) and risk of developing ipsilateral invasive breast cancer and ipsilateral DCIS after treatment, and stage and subtype of ipsilateral invasive breast can ... Full text Link to item Cite

Growth Dynamics of Ductal Carcinoma in Situ Recapitulate Normal Breast Development.

Journal Article bioRxiv · October 2, 2023 Ductal carcinoma in situ (DCIS) and invasive breast cancer share many morphologic, proteomic, and genomic alterations. Yet in contrast to invasive cancer, many DCIS tumors do not progress and may remain indolent over decades. To better understand the heter ... Full text Link to item Cite

Test sensitivity in a prospective cancer screening program: A critique of a common proxy measure.

Journal Article Stat Methods Med Res · June 2023 The true sensitivity of a cancer screening test, defined as the frequency with which the test returns a positive result if the cancer is present, is a key indicator of diagnostic performance. Given the challenges of directly assessing test sensitivity in a ... Full text Link to item Cite

Surveillance Imaging after Primary Diagnosis of Ductal Carcinoma in Situ.

Journal Article Radiology · April 2023 Background Guidelines recommend annual surveillance imaging after diagnosis of ductal carcinoma in situ (DCIS). Guideline adherence has not been characterized in a contemporary cohort. Purpose To identify uptake and determinants of surveillance imaging in ... Full text Link to item Cite

Abstract IA018: Opportunity for interception as a driver of benefit in cancer early detection: implications for multi-cancer early detection testing

Conference Cancer Prevention Research · January 1, 2023 AbstractEarly detection cannot succeed unless there is adequate opportunity for cancer to be diagnosed and intercepted within its early preclinical phase. An understanding of opportunity for early detection ... Full text Cite

A web-based personalized decision support tool for patients diagnosed with ductal carcinoma in situ: development, content evaluation, and usability testing.

Conference Breast Cancer Res Treat · April 2022 PURPOSE: Patients diagnosed with ductal carcinoma in situ (DCIS) face trade-offs when deciding among different treatments, including surgery, radiation, and endocrine therapy. A less chosen option is active monitoring. While evidence from clinical trials i ... Full text Link to item Cite

Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort.

Journal Article Ann Intern Med · April 2022 BACKGROUND: Mammography screening can lead to overdiagnosis-that is, screen-detected breast cancer that would not have caused symptoms or signs in the remaining lifetime. There is no consensus about the frequency of breast cancer overdiagnosis. OBJECTIVE: ... Full text Link to item Cite

MITI minimum information guidelines for highly multiplexed tissue images.

Journal Article Nat Methods · March 2022 The imminent release of tissue atlases combining multi-channel microscopy with single cell sequencing and other omics data from normal and diseased specimens creates an urgent need for data and metadata standards that guide data deposition, curation and re ... Full text Link to item Cite

Abstract P1-22-02: Subsequent risk of ipsilateral breast events in a multinational DCIS cohort of 48.619 patients: A meta-analysis within the PRECISION consortium

Conference Cancer Research · February 15, 2022 AbstractBackground: The PRECISION (PREvent ductal Carcinoma In Situ Invasive Overtreatment Now) CRUK Grand Challenge project focusses on discriminating hazardous from indolent ductal carcinoma in situ (DCIS) ... Full text Cite

Abstract GS4-06: Estimation of breast cancer overdiagnosis in a US breast screening cohort

Conference Cancer Research · February 15, 2022 AbstractBackground. Breast cancer screening is subject to overdiagnosis, that is the mammographic detection of cancers that would not become symptomatic or otherwise cause harm in the absence of screening. T ... Full text Cite

Ductal Carcinoma in Situ: State-of-the-Art Review.

Journal Article Radiology · February 2022 Ductal carcinoma in situ (DCIS) is a nonobligate precursor of invasive cancer, and its detection, diagnosis, and management are controversial. DCIS incidence grew with the expansion of screening mammography programs in the 1980s and 1990s, and DCIS is view ... Full text Link to item Cite

A Bayesian hierarchical model to estimate DNA methylation conservation in colorectal tumors.

Journal Article Bioinformatics · December 22, 2021 MOTIVATION: Conservation is broadly used to identify biologically important (epi)genomic regions. In the case of tumor growth, preferential conservation of DNA methylation can be used to identify areas of particular functional importance to the tumor. Howe ... Full text Link to item Cite

Long-term risk of subsequent ipsilateral lesions after surgery with or without radiotherapy for ductal carcinoma in situ of the breast.

Journal Article Br J Cancer · November 2021 BACKGROUND: Radiotherapy (RT) following breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS) reduces ipsilateral breast event rates in clinical trials. This study assessed the impact of DCIS treatment on a 20-year risk of ipsilateral DCIS (i ... Full text Link to item Cite

Disparities in surveillance imaging after breast conserving surgery for primary DCIS.

Conference Journal of Clinical Oncology · May 20, 2021 6516 Background: Due to the elevated risk of ipsilateral invasive breast cancer (iIBC) after diagnosis with primary ductal carcinoma in situ (DCIS), professional guidelines recommend surveillance screening within 6-12 months (mo) ... Full text Cite

Time-varying survival effects for squamous cell carcinomas at oropharyngeal and nonoropharyngeal head and neck sites in the United States, 1973-2015.

Journal Article Cancer · December 1, 2020 BACKGROUND: Anatomical site is strongly associated with head and neck cancer etiology, and etiology and patient sociodemographic characteristics are prognostic factors for survival. It is not known whether the effects of these predictors persist over the p ... Full text Link to item Cite

Auto-antibodies to p53 and the Subsequent Development of Colorectal Cancer in a U.S. Prospective Cohort Consortium.

Journal Article Cancer Epidemiol Biomarkers Prev · December 2020 BACKGROUND: Auto-antibodies to tumor suppressor p53 are found in a subset of patients with colorectal cancer. A recent prospective study in the United States has reported a significant 1.8-fold increased odds for colorectal cancer development with prediagn ... Full text Link to item Cite

Relationship Between HCAHPS Scores and Survey Response Rate Is Linked to Hospital Size.

Journal Article J Patient Exp · December 2020 Patient experience is an important dimension of health care quality and is assessed using the standard Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for inpatients. The HCAHPS scores may vary based on survey response rate ... Full text Link to item Cite

Abstract PR02: Inferring the evolutionary dynamics of ductal carcinoma in situ through multi-regional sequencing and mathematical modeling

Conference Cancer Research · November 1, 2020 AbstractIntroduction. The natural history of preinvasive breast cancer, or ductal carcinoma in situ (DCIS) remains poorly understood. Overcoming this gap would allow risk-appropriate treatment for patients d ... Full text Cite

Association of Combined Sero-Positivity to Helicobacter pylori and Streptococcus gallolyticus with Risk of Colorectal Cancer.

Journal Article Microorganisms · October 30, 2020 Previously, we found that risk of colorectal cancer (CRC) is increased in individuals with serum antibody response to both Helicobacter pylori (HP) Vacuolating Cytotoxin (VacA) toxin or Streptococcus gallolyticus (SGG) pilus protein Gallo2178. In the prese ... Full text Link to item Cite

Risk for Upgrade to Malignancy After Breast Core Needle Biopsy Diagnosis of Lobular Neoplasia: A Systematic Review and Meta-Analysis.

Journal Article J Am Coll Radiol · October 2020 PURPOSE: Lobular neoplasia (LN) detected on breast core needle biopsy is frequently managed with surgical excision because of concern for undersampled malignancy. The authors performed a systematic review and meta-analysis to estimate the risk for upgrade ... Full text Link to item Cite

Withdrawal of Life-supporting Treatment in Severe Traumatic Brain Injury.

Journal Article JAMA Surg · August 1, 2020 IMPORTANCE: There are limited data on which factors affect the critical and complex decision to withdraw life-supporting treatment (LST) in patients with severe traumatic brain injury (sTBI). OBJECTIVE: To determine demographic and clinical factors associa ... Full text Link to item Cite

Modeling the natural history of ductal carcinoma in situ based on population data.

Journal Article Breast Cancer Res · May 27, 2020 BACKGROUND: The incidence of ductal carcinoma in situ (DCIS) has increased substantially since the introduction of mammography screening. Nevertheless, little is known about the natural history of preclinical DCIS in the absence of biopsy or complete excis ... Full text Link to item Cite

The Human Tumor Atlas Network: Charting Tumor Transitions across Space and Time at Single-Cell Resolution.

Journal Article Cell · April 16, 2020 Crucial transitions in cancer-including tumor initiation, local expansion, metastasis, and therapeutic resistance-involve complex interactions between cells within the dynamic tumor ecosystem. Transformative single-cell genomics technologies and spatial mu ... Full text Open Access Link to item Cite

Minimal barriers to invasion during human colorectal tumor growth.

Journal Article Nat Commun · March 9, 2020 Intra-tumoral heterogeneity (ITH) could represent clonal evolution where subclones with greater fitness confer more malignant phenotypes and invasion constitutes an evolutionary bottleneck. Alternatively, ITH could represent branching evolution with invasi ... Full text Link to item Cite

Response to Habel and Buist.

Journal Article J Natl Cancer Inst · February 1, 2020 Full text Link to item Cite

Surgical decision making in the setting of severe traumatic brain injury: A survey of neurosurgeons.

Journal Article PLoS One · 2020 BACKGROUND: Surgical decision-making in severe traumatic brain injury (TBI) is complex. Neurosurgeons weigh risks and benefits of interventions that have the potential to both maximize the chance of recovery and prolong suffering. Inaccurate prognosticatio ... Full text Link to item Cite

Cancer Outcomes in DCIS Patients Without Locoregional Treatment.

Journal Article J Natl Cancer Inst · September 1, 2019 BACKGROUND: The vast majority of women diagnosed with ductal carcinoma in situ (DCIS) undergo treatment. Therefore, the risks of invasive progression and competing death in the absence of locoregional therapy are uncertain. METHODS: We performed survival a ... Full text Link to item Cite

Incidence of Ductal Carcinoma In Situ in the United States, 2000-2014.

Journal Article Cancer Epidemiol Biomarkers Prev · August 2019 BACKGROUND: In absence of definitive molecular risk markers, clinical management of patients diagnosed with ductal carcinoma in situ (DCIS) remains largely guided by patient and tumor characteristics. In this study, we analyzed recent trends in DCIS incide ... Full text Link to item Cite

Growth Dynamics of Mammographic Calcifications: Differentiating Ductal Carcinoma in Situ from Benign Breast Disease.

Journal Article Radiology · July 2019 Background Most ductal carcinoma in situ (DCIS) lesions are first detected on screening mammograms as calcifications. However, false-positive biopsy rates for calcifications range from 30% to 87%. Improved methods to differentiate benign from malignant cal ... Full text Link to item Cite

Estimating the frequency of indolent breast cancer in screening trials.

Journal Article Stat Methods Med Res · April 2019 Cancer screening can detect cancer that would not have been detected in a patient's lifetime without screening. Standard methods for analyzing screening data do not explicitly account for the possibility that a fraction of tumors may remain latent indefini ... Full text Link to item Cite

Identification of the Fraction of Indolent Tumors and Associated Overdiagnosis in Breast Cancer Screening Trials.

Journal Article Am J Epidemiol · January 1, 2019 It is generally accepted that some screen-detected breast cancers are overdiagnosed and would not progress to symptomatic cancer if left untreated. However, precise estimates of the fraction of nonprogressive cancers remain elusive. In recognition of the w ... Full text Link to item Cite

Epigenetic Heterogeneity in Human Colorectal Tumors Reveals Preferential Conservation And Evidence of Immune Surveillance.

Journal Article Sci Rep · November 23, 2018 Genomic intratumoral heterogeneity (ITH) is common in cancers, but the extent of phenotypic ITH is uncertain because most subclonal mutations are passengers. Since tumor phenotypes are largely driven by epigenetics, methylomic analyses can provide insights ... Full text Link to item Cite

Spatial mutation patterns as markers of early colorectal tumor cell mobility.

Journal Article Proc Natl Acad Sci U S A · May 29, 2018 A growing body of evidence suggests that a subset of human cancers grows as single clonal expansions. In such a nearly neutral evolution scenario, it is possible to infer the early ancestral tree of a full-grown tumor. We hypothesized that early tree recon ... Full text Link to item Cite

Surgical Upstaging Rates for Vacuum Assisted Biopsy Proven DCIS: Implications for Active Surveillance Trials.

Journal Article Ann Surg Oncol · November 2017 PURPOSE: This study was designed to determine invasive cancer upstaging rates at surgical excision following vacuum-assisted biopsy of ductal carcinoma in situ (DCIS) among women meeting eligibility for active surveillance trials. METHODS: Patients with va ... Full text Link to item Cite

Programmable assembly of pressure sensors using pattern-forming bacteria.

Journal Article Nat Biotechnol · November 2017 Biological systems can generate microstructured materials that combine organic and inorganic components and possess diverse physical and chemical properties. However, these natural processes in materials fabrication are not readily programmable. Here, we u ... Full text Link to item Cite

Modeling of US Human Papillomavirus (HPV) Seroprevalence by Age and Sexual Behavior Indicates an Increasing Trend of HPV Infection Following the Sexual Revolution.

Journal Article J Infect Dis · September 1, 2017 BACKGROUND: The United States has experienced an increase in the incidence of human papillomavirus (HPV)-related cancers that are not screen-detectable. It has been hypothesized, but not directly demonstrated, that this is due to increasing HPV prevalence ... Full text Link to item Cite

Mechanistic mathematical models: An underused platform for HPV research.

Journal Article Papillomavirus Res · June 2017 Health economic modeling has become an invaluable methodology for the design and evaluation of clinical and public health interventions against the human papillomavirus (HPV) and associated diseases. At the same time, relatively little attention has been p ... Full text Link to item Cite

Bone remodeling as a spatial evolutionary game.

Journal Article J Theor Biol · April 7, 2017 Bone remodeling is a complex process involving cell-cell interactions, biochemical signaling and mechanical stimuli. Early models of the biological aspects of remodeling were non-spatial and focused on the local dynamics at a fixed location in the bone. Se ... Full text Link to item Cite

Spatial Measures of Genetic Heterogeneity During Carcinogenesis.

Journal Article Bull Math Biol · February 2017 In this work we explore the temporal dynamics of spatial heterogeneity during the process of tumorigenesis from healthy tissue. We utilize a spatial stochastic model of mutation accumulation and clonal expansion in a structured tissue to describe this proc ... Full text Link to item Cite

Quantifying the Dynamics of Field Cancerization in Tobacco-Related Head and Neck Cancer: A Multiscale Modeling Approach.

Journal Article Cancer Res · December 15, 2016 High rates of local recurrence in tobacco-related head and neck squamous cell carcinoma (HNSCC) are commonly attributed to unresected fields of precancerous tissue. Because they are not easily detectable at the time of surgery without additional biopsies, ... Full text Link to item Cite

Outcomes of Active Surveillance for Ductal Carcinoma in Situ: A Computational Risk Analysis.

Journal Article J Natl Cancer Inst · May 2016 BACKGROUND: Ductal carcinoma in situ (DCIS) is a noninvasive breast lesion with uncertain risk for invasive progression. Usual care (UC) for DCIS consists of treatment upon diagnosis, thus potentially overtreating patients with low propensity for progressi ... Full text Link to item Cite

Collective Space-Sensing Coordinates Pattern Scaling in Engineered Bacteria.

Journal Article Cell · April 21, 2016 Scale invariance refers to the maintenance of a constant ratio of developing organ size to body size. Although common, its underlying mechanisms remain poorly understood. Here, we examined scaling in engineered Escherichia coli that can form self-organized ... Full text Link to item Cite

Trends in Treatment Patterns and Outcomes for Ductal Carcinoma In Situ.

Journal Article J Natl Cancer Inst · December 2015 BACKGROUND: Impact of contemporary treatment of pre-invasive breast cancer (ductal carcinoma in situ [DCIS]) on long-term outcomes remains poorly defined. We aimed to evaluate national treatment trends for DCIS and to determine their impact on disease-spec ... Full text Link to item Cite

Impact of coverage-dependent marginal costs on optimal HPV vaccination strategies.

Journal Article Epidemics · June 2015 The effectiveness of vaccinating males against the human papillomavirus (HPV) remains a controversial subject. Many existing studies conclude that increasing female coverage is more effective than diverting resources into male vaccination. Recently, severa ... Full text Open Access Link to item Cite

HPV clearance and the neglected role of stochasticity.

Journal Article PLoS Comput Biol · March 2015 Clearance of anogenital and oropharyngeal HPV infections is attributed primarily to a successful adaptive immune response. To date, little attention has been paid to the potential role of stochastic cell dynamics in the time it takes to clear an HPV infect ... Full text Open Access Link to item Cite

Mathematical Modeling of Cancer Metastases

Chapter · January 1, 2015 Most cancer types develop the ability to leave their site of origin and spread to distant organs to form metastases, also called secondary cancers. Metastases are the most common cause of death among cancer patients, and hence there is an immense clinical ... Full text Cite

Multifocality and recurrence risk: a quantitative model of field cancerization.

Journal Article J Theor Biol · August 21, 2014 Primary tumors often emerge within genetically altered fields of premalignant cells that appear histologically normal but have a high chance of progression to malignancy. Clinical observations have suggested that these premalignant fields pose high risks f ... Full text Link to item Cite

Temporal control of self-organized pattern formation without morphogen gradients in bacteria.

Journal Article Mol Syst Biol · October 8, 2013 Diverse mechanisms have been proposed to explain biological pattern formation. Regardless of their specific molecular interactions, the majority of these mechanisms require morphogen gradients as the spatial cue, which are either predefined or generated as ... Full text Link to item Cite

On the well-posedness of the stochastic Allen-Cahn equation in two dimensions

Journal Article Journal of Computational Physics · March 20, 2012 White noise-driven nonlinear stochastic partial differential equations (SPDEs) of parabolic type are frequently used to model physical systems in space dimensions d= 1, 2, 3. Whereas existence and uniqueness of weak solutions to these equations are well es ... Full text Cite

Triviality of the 2D stochastic Allen-Cahn equation

Journal Article Electronic Journal of Probability · January 1, 2012 Full text Cite

Osteoprotegerin in bone metastases: mathematical solution to the puzzle.

Journal Article PLoS Comput Biol · 2012 Bone is a common site for cancer metastasis. To create space for their growth, cancer cells stimulate bone resorbing osteoclasts. Cytokine RANKL is a key osteoclast activator, while osteoprotegerin (OPG) is a RANKL decoy receptor and an inhibitor of osteoc ... Full text Link to item Cite

The cellular dynamics of bone remodeling: A mathematical model

Journal Article SIAM Journal on Applied Mathematics · April 27, 2010 The mechanical properties of vertebrate bone are largely determined by a process which involves the complex interplay of three different cell types. This process is called bone remodeling and occurs asynchronously at multiple sites in the mature skeleton. ... Full text Cite

Mathematical modeling of spatio-temporal dynamics of a single bone multicellular unit.

Journal Article J Bone Miner Res · May 2009 During bone remodeling, bone-resorbing osteoclasts and bone-forming osteoblasts are organized in bone multicellular units (BMUs), which travel at a rate of 20-40 mum/d for 6-12 mo, maintaining a cylindrical structure. However, the interplay of local BMU ge ... Full text Link to item Cite

Thermal quantum electrodynamics of nonrelativistic charged fluids.

Journal Article Phys Rev E Stat Nonlin Soft Matter Phys · April 2007 The theory relevant to the study of matter in equilibrium with the radiation field is thermal quantum electrodynamics (TQED). We present a formulation of the theory, suitable for nonrelativistic fluids, based on a joint functional integral representation o ... Full text Link to item Cite