Many women with a common form of breast cancer which is in the early stage can skip chemotherapy without lowering their chances of getting better. A major study used genetic testing to find out how each patient was at risk.
This study is the largest one on breast cancer treatment. The results show that almost 70,000 patients a year in the United States and many other women from all over the world could skip chemo.
The study leader is Dr. Joseph Sparano (Montefiore Medical Center, New York). He said that:
“The impact is tremendous.”
Sparano added that many women don’t need extra treatment or therapy after surgery.
The results of the study were discussed at the American Society of Clinical Oncology conference in Chicago, which took place over the weekend. The paper was also published in the New England Journal of Medicine.
Cancer treatments and care have evolved over time, and now doctors either use it in lower doses or short periods, or they replace it with gene-targeting therapies, hormone blockers or immune system treatments.
The study was done on 10,273 patients. They took a test called Oncotype DX, which uses a sample of biopsy to measure how genes that promote cell growth respond to hormone therapy and if there is a risk for cancer to recur.
From all the patients, 17% of them had a high-risk, so they needed chemo. 16% of the patients had low-risk, so they could skip chemo, and the 67% of the women had an intermediate risk.
Half of the group with intermediate risk received chemo. After nine years, 94% of both women with chemo and without chemo were alive. 84% of them had no sign of cancer.
The study showed that there was no difference between the women from the intermediate group that received and didn’t receive chemotherapy. A few women younger than 50 benefit from chemo.
What Do the Doctors Recommend?
According to doctors, women like those in the study should get gene testing to find out how to continue with cancer care. Dr. Richard Schilsky is the chief medical officer of the oncology society, recommending Oncotype DX, which is covered by many insurers.
Dr. Harold Burstein (Dana-Farber Cancer Institute, Boston) Said that it’s relieving to know that tests could solve the question of who needs chemo. He said that women think “if I don’t get chemotherapy I’m going to die, and if I get chemo I’m going to be cured.” However, in some cases, there is only a small improvement or none.
Dr. Jennifer Litton (MD Anderson Cancer Center, Houston) said that patients with cancer could differ:
“Risk to one person is not the same thing as risk to another. There are some people who say, ’I don’t care what you say, I’m never going to do chemo.’” She advises people to have gene test and see if they need or don’t need chemo.
Andre Blair s is the lead editor for Advocator.ca. He holds a B.A. in Psychology from the University of Toronto, and a Master of Science in Public Health (M.S.P.H.) from the School of Public Health, Department of Health Administration, at the University of North Carolina at Chapel Hill. Andre specializes in environmental health, but writes on a variety of issues.