Tuesday, 16 October, 2018

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

Participant Adine Usher met last month with study leader Dr. Joseph Sparano at the Montefiore and Albert Einstein College of Medicine in New York For some breast cancer patients, the chemo decision may now be easier
Carol Daniels | 07 June, 2018, 06:12

"While this practice has contributed to declining rates in breast cancer mortality, "...the majority of patients may receive chemotherapy unnecessarily".

After nine years, 94 percent of the women in both groups were still alive. And we have known that also.

As of January 2018, there are more than 3.1 million women with a history of breast cancer in the U.S. This includes women now being treated and women who have finished treatment.

The trial results showed that for women in the intermediate recurrence score group, endocrine therapy was no less effective than hormone therapy plus chemotherapy at prolonging disease-free survival.

A 21-gene test called Oncotype Dx that has been around since 2004 has helped guide some decisions, post-surgery.

Based on all this, Sparano's team concluded that chemotherapy is now unwarranted in women over 50 with this type of breast cancer who have an Oncotype score under 26.

"Oncologists have been getting much smarter about dialing back treatment so that it doesn't do more harm than good", Steven Katz, a University of MI researcher who examines medical decisionmaking, told The Washington Post.

Researchers say, the results allowed them to separate women who would benefit from chemotherapy due to a higher risk of recurrent breast cancer, and those who tested at a lower risk and do not need chemo for treatment.

Past research has shown that women with scores between 0 and 10 could skip chemotherapy, while those with scores over 25 benefited from adding chemotherapy to their hormonal treatment plan.

This is the largest study ever done on breast cancer treatment.

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This could affect up to 70,000 women a year in the USA and many more worldwide, the study noted.

"It is very important that we record all possible events, including recurrence and toxicity, and an even longer follow-up will also give us the opportunity to continue evaluating our patients in other areas, for example quality of life and wellbeing", Poortmans said.

A new study published Sunday in the New England Journal of Medicine may drastically change how medical professionals approach treating women diagnosed with breast cancer.

About 85% of breast cancers occur in women who have no family history of breast cancer. But the disease returned, failed to respond to treatment and spread to her right breast.

"Irish women contributed significantly to this trial and can be rightly proud of their input into improving care for future women who present with breast cancer", Prof Keane said.

But it has many torturing side-effects including vomiting, hair loss, fatigue, anemia, nerve pain and, in rare cases, heart failure and leukaemia.

"Because this is a huge study".

The trial is due to enrol around 330 patients to fully put the technique through its paces, and should be able to generate statistically-validated results in 2023.

"With the recent consultation on tumour profiling tests having already closed, it is crucial that Nice has the opportunity to consider these results as soon as possible", Baroness Morgan said.

The presentation and publication of the data marks an "extraordinary day" for doctors and patients, commented ASCO expert Harold Burstein, MD, PhD, of Dana-Farber Cancer Institute in Boston.

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