Health Care

Breast cancer: Test means fewer women will need chemo

Breast cancer: Test means fewer women will need chemo

For women 50 or younger, chemotherapy is unwarranted for those with an Oncotype score under 16 - about 40 percent of breast cancers in this age group, the researchers said.

"It feels miraculous and I am beyond amazed that I have now been free of cancer for two years", she told the media.

Trial Assigning IndividuaLized Options for Treatment (Rx), or TAILORx, successfully confirmed the benefit of endocrine therapy alone in patients with early-stage breast cancer who have an Oncotype DX Breast Recurrence Score of 11 to 25.

"But because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is in a sense a blueprint we can use for the treatment of many types of cancer".

The TAILORx trial used the Oncotype DX test, now available on the NHS, which allows doctors to predict the likelihood of the breast cancer coming back.

The researchers were specifically interested in women who scored 10 to 25 on the test - scores that fall in the range of a medium risk of the cancer returning after surgery.

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Patients scoring 26 or higher on the scale do benefit and receive chemotherapy. A new U.S. study, TAILORx, has shown that up to 70% of these women could avoid this painful treatment, which has multiple side effects.

Irish oncologists have been giving progressively less chemotherapy to low risk women as evidence emerged in recent years. Nine-year rates were similar for iDFS (83.3% vs 84.3%), DRFI (94.5% vs 95.0%), RFI (92.2% vs 92.9%), and OS (93.9% vs 93.8%) for the RS 11 to 25 arm.

The study, which used genetic testing and included about 10,000 patients, revealed that women with smaller-sized, estrogen-fueled tumors that had not spread to the lymph nodes fared just as well without chemo as those who received it. "Practically speaking, this means that thousands of women will be able to avoid chemotherapy, with all of its side effects, while still achieving excellent long-term outcomes", said ASCO expert Dr Harold Burstein.

These women would instead be treated with radiation, surgery, and hormone therapy.

Carey pointed to some "grey areas" at the boundaries of the recurrance scores that need futher investigation, and said patients would need to discuss these details with their doctors before any decisions on treatement are made.

"It also helps identify those women with this disease who really do benefit from the chemotherapy", he said.

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The study, led by the Montefiore Medical Centre in NY, found women older than 50 with this form of breast cancer and a score of up to 25 did not need chemotherapy. "Chemotherapy has saved a tremendous amount of lives, and will continue to do so", Dr. José Baselga said, via NPR.

Chemotherapy may be avoided in about 70% of early-stage breast cancer patients, thus limiting chemotherapy to the 30% for whom it can be predicted to be beneficial, a study released on Sunday (3 June) shows. A little boost can outweigh the risks of the treatment for these patients.

There are typically more than 55,000 new cases of breast cancer diagnosed in the United Kingdom each year, while around 11,500 people die from the disease.

The success, reported in the journal Nature Medicine, is all the more remarkable because breast cancers, like prostate and ovarian cancer, have relatively few mutations, which makes them harder for the immune system to spot amid the body's healthy tissues. Scientists are certainly on the right track to finding an effective way to battle cancer, but a lot more work lies ahead to verify these treatments are safe and effective for a large number of people. "I had a tumour in my chest that I could feel shrinking", she said.

The trial results are the latest piece of the puzzle on how to treat early-stage breast cancer.

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