Most Breast Cancer Patients May Not Need Chemo

                When is it safe for a woman with breast cancer to skip chemotherapy? A new study helps answer that question, based on test of gene activity in tumours. It found that nearly half of women with early stage breast cancer who would traditionally receive chemo can avoid it, with little risk of the cancer coming back or spreading in the next five years. The so called genomic test measures the activity of genes that control the growth and spread of cancer, and can identify women with a low risk of recurrence and therefore little to gain from chemo.

                More and more evidence is mounting that there is a substantial number of women with breast cancer who will not need chemotherapy to do well. The researchers estimated that their findings, would apply to 35,000 to 40,000 women a year in the United States, and 60,000 to 70,000 in Europe. They are patients with early disease who because of tumours size, cancerous lymph nodes and other factors would normally be prescribed chemo. Genomic tests, which doctors gave been using for about 10 years in some breast cancer patients, are part of a growing effort to spare women from chemo and its harsh side effects whenever it is safe to do so. But the decision to forgo a potentially lifesaving treatment is never taken lightly, and doctors have been eager for more data to make sure they are on the right path.

                The new study is one of the largest and most rigorous trials of genomic testing, and offers reassurance to doctors and patients that the technology can be trusted to help identify patients who do not need chemo. But an editorial accompanying the report said the study was not the final word, and additional research now underway would provide more clarity. Although women who skipped chemo had low recurrence rates, their rates were slightly higher than those of women who had chemo.