Published: Tue, June 05, 2018
Medicine | By Tracy Klein

Many women with common breast cancer can safely skip chemo, study says

Many women with common breast cancer can safely skip chemo, study says

Dr. Jennifer Ashton, ABC News" Chief Medical Correspondent, says, "This is for the woman at intermediate risk for that cancer to reoccur. No less daunting than the diagnosis itself was the prospect of chemotherapy and its associated side-effects - hair loss, nausea, etc. After surgery and radiation, those women were randomly assigned to receive chemotherapy with an estrogen-blocking medication or just the estrogen hormone blocker.

"We can spare thousands and thousands of women from getting toxic treatment that really wouldn't benefit them", said Dr. Ingrid A. Mayer, from Vanderbilt University Medical Center, an author of the study, as cited by The New York Times.

Oncotype Dx is a test created to predict the risk of breast cancer coming back. The test looks at 21 different genes known to play a role in the development of breast cancer. Similar tests including one called MammaPrint may also be used. But this decision is being reviewed.

Thousands of women have been tested over the years using Oncotype DX to help determine the true effectiveness of chemo.

What did the study show?

The breast cancer study gave 10,273 patients a test called Oncotype DX, which uses a biopsy sample to measure the activity of genes involved in cell growth and response to hormone therapy, to estimate the risk that a cancer will recur. She had a lumpectomy, followed by a mastectomy, and had a recurrence score of 12 or 13, which put her in the middle range.

There were 1.7 million new breast cancer cases in 2012, according to the World Cancer Research Fund International, making it the most common form of cancer in women globally.

The experiment led to "complete durable regression" of the cancer that had spread to Judy Perkins' liver, the team said, writing in the journal Nature Medicine. Those who score high-26 to 100-receive both hormone therapy and chemotherapy.

According to the Centers for Disease Control and Prevention (CDC), about 236,000 women and 2,100 men were diagnosed with breast cancer in 2014, the most recent year for which figures are available.

Whether or not to have the treatment is a bad dilemma for many women with certain types of breast cancer as they often don't have clear-cut answers on the benefits.

"With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70 percent of patients who are diagnosed with the most common form of breast cancer", Dr. Albain said.

Still, he acknowledged that most patients with this form of advanced cancer will die within months, and "we need to do a lot more work".

The findings, from the largest breast cancer treatment trial ever conducted, showed that most patients who have an intermediate risk of a cancer recurrence - a group that numbers 65,000 women a year in the United States - can avoid chemotherapy and its often debilitating side effects.

Because of her work as a nurse, she was familiar with chemotherapy's sometimes harsh effects.

But in a discussion of the results, Dr Lisa Carey, from the University of North Carolina in the USA, drew attention to some of the subtle differences between the groups. But until this new research, patients and doctors didn't have all of the information they needed to recommend treatment based on a patient's particular results. This left a lot of women, an estimated 65,000 in the USA each year, in a gray zone, unsure if they would benefit from chemo. The results were presented at the annual cancer conference (ASCO) held in Chicago.

Dr Ring said the publication of the trial results was "timely", adding: "I would be very, very keen that the TAILORx results are incorporated into that evaluation".

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