Many breast cancer patients can skip chemo, confirms landmark study

Pancreatic cancer patients could live more than twice as long if given chemotherapy and radiation treatment before surgery

Pancreatic cancer patients could live more than twice as long if given chemotherapy and radiation treatment before surgery

Most women with the most common form of early-stage breast cancer can safely skip chemotherapy without hurting their chances of beating the disease, doctors are reporting from a landmark study that used genetic testing to gauge each patient's risk.

He says breast cancer patients fall into three categories: Low-risk, which does not require chemo, high-risk - which demands the treatment, and an intermediate category they call "the grey area", where he says this new research now clarifies. The study found that for women with hormone receptor (HR)-positive, HER2-negative, axillary lymph node-negative breast cancer, treatment with chemotherapy and hormone therapy after surgery is not more beneficial than treatment with hormone therapy alone. In addition, women 50 and younger who scored between zero and 15 could be spared chemotherapy.

"Until now, we've been able to recommend treatment for women with these cancers at high and low risk of recurrence, but women at intermediate risk have been uncertain about the appropriate strategy to take", said Jeffrey Abrams, M.D., associate director of NCI's Cancer Therapy Evaluation Program. Furthermore, 83.3% of those from the endocrine-only group were cancer free, while 84.3% of those from the combined therapy were cancer free. The study confirmed that using a 21-gene analyzation to assess cancer recurrence risk can successfully indicate whether or not a woman needs to undergo invasive and unnecessary chemotherapy treatment. Nine years after the treatment was administered, 93.8% were still alive in the chemo group, while 93.9% were still alive in the endocrine-only group.

There are several ways you can lower your risk of breast cancer: Get an annual breast screening, for most women this begins at age 40; be physically active and exercise; reduce lifetime weight by making healthy food choices; avoid smoking; limit alcohol intake; and practice meditation, do yoga or find other ways to reduce stress. The test allows clinicians to assign a patient a recurrence score from 0 to 100. These come from small, early stage studies through to large randomised clinical trials. Without the stamp money, the study may never have been done, he said.

But some of the more striking developments unveiled in the past week involve breast cancer. In the old days we'd just have a bucket: 'breast cancer, ' 'prostate cancer, ' 'lung cancer.' Now we can look at the subtypes of cancer by looking at the genes and give the right treatment to the right patient at the right time.

The genomic assay used in the trial was the Oncotype DX Breast Recurrence Score test from Genomic Health, Inc., Redwood City, California.

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