Gene Test Identifies Breast Cancer Patients Who Can Skip Chemo

“These patients who had low risk scores by Oncotype did extraordinarily well at five years”, said Dr. Hope Rugo, a breast cancer specialist at the University of California, San Francisco, with no role in the study.

Dr. Joseph Sparano, lead author on the study and field expert from Montefiore Medical Center (New York), gave a statement saying that “You can’t do better than that”.

Dr. Mayordomo agrees with the National Cancer Institute study, which found chemotherapy given to a few women with early stage breast cancer does little, if any good.

It is the only genomic test validated for its ability to predict the likelihood of chemotherapy benefit as well as risk of recurrence in early-stage breast cancer.

This finding was published online today by the New England Journal of Medicine. Research shows that less than 10% of patients with early-stage breast cancer actually benefit from chemotherapy and nearly a third of treatment recommendations for United Kingdom patients diagnosed with early breast cancer change once the result of the Oncotype DX test is known.

“To a few extent, it’s surprising because cancer treatment is quite toxic”, he said, “and we know most chemotherapy drugs cross the placenta”. The test that measures these factors to determine whether women are low-risk, high-risk, or somewhere in between-called Oncotype DX-has been on the market since 2004.

Researchers looked at a group of 129 European children, aged one to three, who were exposed to chemotherapy, radiotherapy, surgery and drug treatments while in the womb. About 16 percent of the women scored low on the test and thus, received only anti-hormone therapy, no chemotherapy. It should be noted, however, that the results for these groups are still pending, and that the research is still ongoing. The study proved that there is no need for chemo for women in low risk group. At the end of the study, less than two percent of the hormone-only group had the cancer spread and the survival rate was 98 percent overall. About 94 percent were free of any invasive cancer, including new cancers at other sites or in the opposite breast.

During the study, more than 10,000 breast cancer patients were screened. The selection of patients for chemotherapy treatment was consistent with the recurrence-score results as recommended in treatment guidelines.

Even though Harbison didn’t qualify for the test, “I’m all for it, anything not to go through chemo”, she says.

Prof Amant said: ‘In most cases, they were born prematurely due to a medical decision to induce preterm so as to continue cancer treatment after the delivery’. Although the lymph nodes were not involved, the tumors had other features that indicated chemotherapy should be given, followed by tamoxifen or other endocrine therapy pills. Doctors get paid $7 more from Medicare and $20 more from private insurers for mammograms done with computer-assisted technology.