New study says women with early stage breast cancer can avoid chemotherapy

Adine Usher 78 meets with breast cancer study leader Dr. Joseph Sparano at the Montefiore and Albert Einstein College of Medicine in the Bronx borough of New York. Usher was one of about 10,000 participants in the study which shows women at low or inter

New study says women with early stage breast cancer can avoid chemotherapy

"It feels miraculous, and I am beyond amazed that I have now been free of cancer for two years", Ms Perkins said.

The researchers who conducted the trial, which was the biggest breast-cancer treatment trial ever, used a gene test called Oncotype DX to gauge recurrence risk.

"It's also highly significant that this outcome suggests reprogramming patients' immune cells as part of a two-pronged attack could be a viable way to treat ER-positive tumours - which could open this approach up to benefit many patients with metastatic breast cancer".

Oncotype Dx is a test created to predict the risk of breast cancer coming back.

WHEN THIS Delhi-based businesswoman was recently diagnosed with early stage breast cancer, her world came crashing down.

Alan Melcher, professor of translational immunotherapy at the Institute of Cancer Research in London, who was not involved in the study said: "The work shows that even cancers like breast cancer, which don't have many antigens, are amenable to this sort of treatment". "Most women in this situation don't need treatment beyond surgery and hormone therapy", he said, and "the rest of them are receiving chemotherapy unnecessarily".

A high recurrence score, above 25, means chemo is advised to ward off a recurrence, while a low score, below 10, means it is not. "The case with other TIL therapies in the past is that they've not been able to expand enough T cells in many patients, there aren't enough to start with".

The nine-year-survival-rate was 93.9 percent without chemotherapy and 93.8 percent with chemotherapy.

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

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.

"I think this is a very significant advance", said Dr Larry Norton, of Memorial Sloan Kettering Cancer Center in NY. African-American women are also more likely than white women to develop hormone-negative breast cancer, a disease type that is unresponsive to hormone therapy drugs and thus more hard to treat. However, this left the majority of women with the condition (those who fall into the 11 - 25 range) and their doctors without clear treatment guidance. "Chemotherapy has saved a tremendous amount of lives, and will continue to do so", Dr. José Baselga said, via NPR.

Dr. Lisa Carey, a breast specialist at the University of North Carolina's Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it.

Previously, the same study had shown that women with a low risk of recurrence can avoid chemo, and other studies had shown that those with a high risk of recurrence should receive it. Chemo typically costs £4,500 per patient so it is set to save the NHS millions.

They represent roughly half of the more than 17,000 new cases of breast cancer diagnosed in Australia every year.

"They were sick all the time", she said.

According to a research article "Epidemiology of breast cancer in Indian women" by Asia-Pacific Journal of Clinical Oncology, in India, breast cancer has been ranked number one cancer among Indian females.

These gene tests are only applicable to patients with early-stage invasive breast cancer, Loyola's Albain says.

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