Thousands could be spared chemotherapy after landmark breast cancer study

For some breast cancer patients, the chemo decision may now be easier

You have got a great prognosis and chemotherapy won't help.

The breast cancer study cast doubt on chemo's necessity in treating women in early stages of the disease where it has not spread to lymph nodes, it is hormone-positive and it is not the type that the drug Herceptin targets.

While much more study is needed, researchers say because all cancers have mutations, this approach could potentially be used to treat many different types of cancer.

Hormone-receptor-positive, axillary node-negative disease accounts for approximately half of all cases of breast cancer in the USA, and the National Institutes of Health has previously recommended adjuvant chemotherapy for most patients, the authors write.

Dr Simon Vincent, director of research at the charity Breast Cancer Now, warned more patients will have to be treated to assess how effective the therapy is. The researchers' published paper is entitled "Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer". The money was used to pay for the gene test, which costs more than $4,000 per person.

Patients with a recurrence score of up to 10 out of 100 have been shown not to benefit from chemotherapy and only hormone treatment is required. "While this practice has contributed to declining rates in breast cancer mortality, "...the majority of patients may receive chemotherapy unnecessarily".

This week, a trial showed that men given just months or weeks to live after being diagnosed with prostate cancer are surviving for more than a year thanks to a breakthrough in immunotherapy treatment.

"Half of all breast cancers are hormone receptor-positive, HER2-negative, and axillary node-negative", noted study author Dr. Joseph Sparano, who helps direct clinical research at the Albert Einstein Cancer Center in New York City.

For women under 50 with a score of 0 to 15, chemo could be skipped.

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Those women should carefully discuss their options with their oncologist, said Brawley, because they would likely be candidates for the more aggressive, dual therapies.

They say the data "provide evidence that that adjuvant chemotherapy was not beneficial in these patients".

Commenting on the findings, Dr Harold Burstein, ASCO expert, said: "This is the most common form of breast cancer in the United States and developed countries and the most challenging decision we make with these patients is whether or not to recommend adjuvant chemotherapy with all its side effects and with its potential benefits". It's called the Oncotype DX test.

"It's going to save tens of thousands of people from having to take unnecessary chemotherapy", said Butler.

The 52-year-old structural engineer had a mastectomy after she was diagnosed in 2003, but a decade later, she found out the cancer had spread and was given a few years to live.

Litton, the MD Anderson oncologist, said doctors need to consider each case on its own merits; she cautioned against ruling out chemo too quickly.

The overall survival rate was similar: 93.9% for those who received hormone therapy alone and 93.8% for those who received both therapies.

Over the years, the Cancer Institute has used its $59.8 million in proceeds for studies trying to improve early detection and to determine which cancers are most unsafe and need heaviest treatment and which are less so.

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