Chemo 'not needed' by 70pc of women with breast cancer

Chemo 'not needed' by 70pc of women with breast cancer

Chemo 'not needed' by 70pc of women with breast cancer

One of the big questions facing women diagnosed with early-stage breast cancer is whether to be treated with chemotherapy to reduce their risks that the cancer will return.

Now, the choice is getting easier for some patients.

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.

The findings could mean that thousands of Canadian women might not have to endure the nausea, hair loss, and other side effects of the chemotherapy medications that can keep cancer at bay but that carry plenty of risks of their own. Oncotype DX has spurred the trend, and is likely to accelerate it.

However, chemotherapy did offer some benefit to women aged 50 and younger who had a cancer recurrence score of 16-25, researchers found. This left a lot of women, an estimated 65,000 in the US each year, in a gray zone, unsure if they would benefit from chemo.

The study, dubbed TAILORx, was also published in the New England Journal of Medicine.

These were divided into groups that will receive chemotherapy followed by hormonal therapy or hormonal therapy alone. Women older than 50 with a midrange risk - defined in the study as a score of 11 to 25 on a tumor test - can skip chemo and just have endocrine therapy.

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.

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

Many women with early-stage breast cancer who would receive chemotherapy under current standards do not actually need it, according to a major global study that is expected to quickly change medical treatment. 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. Those with an intermediate risk were split into two groups: half received surgery and hormone therapy, while half also received chemo.

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Still, the recoveries in the three individual cases now reported represent an important advance, according to the researchers.

In the US, the most recent data shows around 135,000 new cases yearly of the specific breast cancer studied, says Dr. Joseph Sparano, an oncologist at Montefiore Medical Center, a professor of medicine at the Albert Einstein College of Medicine and the lead author of the study. Twenty-five percent of those patients won't qualify for chemotherapy because of age or medical problems.

"It is showing we are now increasingly able to predict who needs what level of treatment and use that to give the least-toxic and most-effective treatment".

Avoiding chemotherapy when it comes to breast cancer treatment is something Starts at 60 readers have already experienced.

For the TAILORx study, scientists recruited over 10,000 women with the most common type of breast cancer, called oestrogen-receptor positive (ER+) HER2-negative breast cancer.

"Chemotherapy has saved a tremendous amount of lives, and will continue to do so", Baselga says.

"My condition deteriorated a lot towards the end, and I had a tumour pressing on a nerve, which meant I spent my time trying not to move at all to avoid pain shooting down my arm".

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

If a patient is considered at "low risk" for recurrence, does she still have to get endocrine therapy? Oncotype DX and other genomic tests have spurred a trend sure to accelerate following Sunday's report. Now only about 60 percent of US patients who could potentially benefit from it are taking the gene test, he says. He expects treatment guidelines to quickly change based on the study, which was conducted by a research group named ECOG-ACRIN. "If we are going to take a step back" from chemotherapy, he said, "we really had to be sure".

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