Chemotherapy is not needed in 70% of cases of breast cancer

Phyllis Laccetti a participant in the TailorX breast cancer study at her home in Ossining NY

About 70% of women diagnosed with the early stages of one of the most common forms of breast cancer might not need chemotherapy as part of treatment, according to the results of a long-awaited study presented at the American Society of Clinical Oncology meeting in Chicago Sunday. Following this "recalibration" of the genetic test, the researchers estimated that chemotherapy was not justified in 70% of cases of breast cancer.

The study's lead author, Dr. Joseph Sparano, the associate director for clinical research at the Albert Einstein Cancer Center in NY, says patients with early stage breast cancer should consider this kind of testing.

"You shouldn't do chemo unless you have to", added Dr. Jack Jacoub, medical oncologist and medical director at the MemorialCare Cancer Institute at the Orange Coast Medical Center in California.

A group of metastatic breast cancer experts has urged policymakers to empower patients with greater choice and participation in their treatment and care, to improve the quality of life of patients, their carers and families.

The study, funded by the National Cancer Institute, foundations and proceeds from the US breast cancer postage stamp, is the latest development in a national trend on cancer treatments.

Dr. Steven Rosenberg, chief of surgery at the National Cancer Institute, was stunned by the response shown by Perkins' body, who had resigned herself to what she thought would be her inevitable end.

He told the BBC: "We think this is a remarkable result".

"These data provide critical reassurance to doctors and patients that they can use genomic information to make better treatment decisions in women with early-stage breast cancer". Most women who fit this criteria need only surgery and hormone therapy, he said. The problem with these cells is that they're too few to help a patient on their own, so the team grew new copies of the cells in the lab, multiplying them dramatically over a period of few weeks, after which they were infused back into the patient. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test. Proceeds from the U.S. Postal Service's breast cancer stamp enabled a landmark study that showed which women need chemo and which do not. "Now that we know many of these women can safely avoid chemotherapy, we can spare them the physical and emotional effects that chemotherapy can have". They also have a score between 11 and 25 on the Oncotype DX Breast Recurrence Score test.

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Women with breast cancer are at risk of having their disease spread to the lymph nodes, and from there elsewhere in the body.

So the biggest unanswered questions involved women in the intermediate-risk category: Did chemo reduce their chance of recurrence? Women older than 50 with a midrange risk - defined in the study as a score of 11 to 25 on a tumour test - can skip chemo and just have endocrine therapy. "It was all gone", she said.

Although this work does indicate that thousands of women can be spared this hard treatment, it doesn't mean skipping chemo is the right choice for all early-stage breast cancer patients.

As many as 65,000 women in the United States alone could be affected by the findings.

While chemotherapy is being dropped for some cases, it's being increased for more aggressive cancers.

Women can have the tendency to turn towards chemo, even if the results have a relatively small benefit, Albain says.

In a paper published in December, Kurian and Katz reported that chemotherapy use was plunging among patients with early-stage breast cancer.

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