CINCINNATI (WKRC) A study just released from the American Society of Clinical Oncology found about 70 percent of women diagnosed with early stage breast cancer may not need chemotherapy.. Researchers in the study reviewed the results of a very reliable genetic test. It assesses recurrence risk.. They found that the group in the middle, not low, not high, didn’t likely benefit from chemotherapy. Hormone therapy could be just as effective.. This was based on a scoring system which can now be assigned to breast cancer tumors.. “We used to give it based on the size of the tumor and then we realized it’s not just how big it is or lymph node involvement but rather how aggressive it is, and this is looking at that aggressiveness, so they took 21 genes, translated that into a number, a score number, and the lower numbers didn’t need chemo, the higher numbers did, and so there was this intermediate group that we didn’t really know about. So, 65 to 75 percent of all breast cancer patients feed on estrogen, that’s the female hormone, so if we block that hormone it’s just as effective in those women with lower numbers on that score as having any chemotherapy,” said Dr. James Maher of the TriHealth Cancer Institute.. Chemotherapy are drugs that can kill cancer, but cause a lot of side effects.. Hormone therapy has fewer side effects, and if it is just as effective, it would generally be less harsh on the body.. So, the critical thing is finding this cancer early, it means you have more choices.. One of those choices now may be not needing chemotherapy.
Helen Roe, Consultant Cancer Nurse, North Cumbria University Hospitals NHS Trust, UK, discusses using Oncotype DX testing for moderate risk breast cancer to see if a patient will benefit from receiving chemotherapy after surgery. Being able to conduct such a test is hugely beneficial for patients as it allows them to start radiotherapy and hormone treatment as soon as possible, and avoid being exposed to the side effects of chemotherapy. From a logistical point of view it allows chairs to be freed for patients undergoing chemotherapy. In period of just of a year, out of 56 patients in the clinic, it was determined that 28 did not need chemotherapy. While different organisations implement the test at different stages, at the Cumbria University Hospitals NHS trust, the decision to take the test is made at the initial multidisciplinary team meeting based on the histology of the patient, before the patient is seen the clinic. This saves anxiety and needless discussions. Originally, patients had to self-fund the tests, but NICE and NHS have now commissioned the test so patients no longer have to pay, and it is now standard practice. In the future she discussed how the test will be done for different tumour sites and alter the criteria slightly for breast cancer patients. The the vital role of nurses in providing information and support to patients is also explained. From discussing what the test will involve, what timeframes the patient should expect, and explaining what the results of the test mean, to supporting the patient if it is decided that the patient should not undertake chemotherapy. Recorded at the 2016 Annual Meeting of the Oncology Nursing Society (ONS), held in Brighton, UK.
Dr. Jennifer Ashton discusses the biggest takeaways from a groundbreaking new study that says most women with an early stage of breast cancer can safely skip chemo.
The decade-long study showed most patients with an intermediate risk of cancer recurrence can avoid chemotherapy without hurting their chances of beating the disease. KARE 11’s Alicia Lewis has the details. https://kare11.tv/2kNfNTA
A new study reveals that many women with early-stage breast cancer can skip chemotherapy without hurting their odds of beating the disease with the use of a gene-activity test, gauging each patient’s risk. (Sept. 28). Subscribe for more Breaking News: http://smarturl.it/AssociatedPress.
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UNDATED (AP) Many women with early-stage breast cancer can skip chemotherapy without hurting their odds of beating the disease good news from a major study that shows the value of a gene-activity test to gauge each patient’s risk. The test accurately identified a group of women whose cancers are so likely to respond to hormone-blocking drugs that adding chemo would do little if any good while exposing them to side effects and other health risks. In the study, women who skipped chemo based on the test had less than a 1 percent chance of cancer recurring far away, such as the liver or lungs, within the next five years. “You can’t do better than that,” said the study leader, Dr. Joseph Sparano of Montefiore Medical Center in New York. An independent expert, Dr. Clifford Hudis of New York’s Memorial Sloan Kettering Cancer Center, agreed. “There is really no chance that chemotherapy could make that number better,” he said. Using the gene test “lets us focus our chemotherapy more on the higher risk patients who do benefit” and spare others the ordeal. The study was sponsored by the National Cancer Institute. Results were published online Monday by the New England Journal of Medicine and discussed at the European Cancer Congress in Vienna. The study involved the most common type of breast cancer early stage, without spread to lymph nodes; hormone-positive, meaning the tumor’s growth is fueled by estrogen or progesterone; and not the type that the drug Herceptin targets. Each year, more than 100,000 women in the United States alone are diagnosed with this. The usual treatment is surgery followed by years of a hormone-blocking drug. But many women also are urged to have chemo, to help kill any stray cancer cells that may have spread beyond the breast and could seed a new cancer later. Doctors know that most of these women don’t need chemo but there are no great ways to tell who can safely skip it. A California company, Genomic Health Inc., has sold a test called Oncotype DX since 2004 to help gauge this risk. The test measures the activity of genes that control cell growth, and others that indicate a likely response to hormone therapy treatment. Past studies have looked at how women classified as low, intermediate or high risk by the test have fared. The new study is the first to assign women treatments based on their scores and track recurrence rates. Of the 10,253 women in the study, 16 percent were classified as low risk, 67 percent as intermediate and 17 percent as high risk for recurrence by the test. The high-risk group was given chemotherapy and hormone-blocking drugs. Women in the middle group were randomly assigned to get hormone therapy alone or to add chemo. Results on these groups are not yet ready the study is continuing. But independent monitors recommended the results on the low-risk group be released, because it was clear that adding chemo would not improve their fate. After five years, about 99 percent had not relapsed, and 98 percent were alive. About 94 percent were free of any invasive cancer, including new cancers at other sites or in the opposite breast. “These patients who had low risk scores by Oncotype did extraordinarily well at five years,” said Dr. Hope Rugo, a breast cancer specialist at the University of California, San Francisco, with no role in the study. “There is no chance that for these patients, that chemotherapy would have any benefit.” Dr. Karen Beckerman, a New York City obstetrician diagnosed with breast cancer in 2011, said she was advised to have chemo but feared complications. A doctor suggested the gene test and she scored very low for recurrence risk. “I was convinced that there was no indication for chemotherapy. I was thrilled not to have to have it,” and has been fine since then, she said. Mary Lou Smith, a breast cancer survivor and advocate who helped design the trial for ECOG, the Eastern Cooperative Oncology Group, which ran it, said she thought women “would be thrilled” to skip chemo. “Patients love the idea of a test” to help reduce uncertainty about treatment, she said. “I’ve had chemotherapy. It’s not pretty.” The test costs,175, which Medicare and many insurers cover. Others besides Oncotype DX also are on the market, and Hudis said he hopes the new study will encourage more, to compete on price and accuracy. “The future is bright” for gene tests to more precisely guide treatment, he said. (IMAGE: MGN)
“Basically, it’s going to spare a lot of unnecessary chemotherapy in patients with breast cancer.” The genomic test for this type of breast cancer, called Oncotype DX, measures the expression of 21. Many women with early breast cancer may not need chemo, study finds Genetic test can help determine treatment for patients with smaller tumors that have not spread to the lymph nodes The new study. Personalising treatment Most progress towards personalising treatment has been in developing genetic tests for breast cancer, performed on tumour samples taken during surgery. One.
Current National Comprehensive Cancer Network (NCCN) guidelines on who should have genetic testing after a breast cancer diagnosis miss about half of people with a genetic mutation linked to the disease, according to a study. The research was published online on Dec. 7, 2018, by the Journal of Clinical Oncology. Some women inherit changes (mutations) in certain genes that increases their risk of breast cancer (and possibly other cancers).
Genetic testing can be done to look for mutations in some of these genes. While testing can be helpful in some cases, not every woman needs to be tested, and the pros and cons need to be considered carefully. Genetic testing is available for hereditary breast and ovarian cancer. Most breast and ovarian cancer is not caused by inherited mutations, so genetic testing will not help most women with a family health history of breast and ovarian cancer.
Genetic testing will not identify the cause for some hereditary breast and ovarian cancers, because the genes affected in these cancers are not yet known. Researchers say a new genetic test for breast cancer patients may indicate whether standard chemotherapy treatments will work. Their study, published in. “Only about 5 to 10% of cancer cases are related to genetics,” says Karen Lu, M.D., co-medical director of the Clinical Cancer Genetics Program at MD Anderson. “Genetic testing is a powerful tool to identify those individuals who are at especially increased risk for. A woman’s lifetime risk of developing breast and/or ovarian cancer is greatly increased if she inherits a harmful mutation in BRCA1 or BRCA2..
Breast cancer: About 12% of women in the general population will develop breast cancer sometime during their lives ().By contrast, a recent large study estimated that about 72% of women who inherit a harmful BRCA1 mutation and about 69% of women who. A genetic test called MammaPrint determined that nearly half the women slated for chemotherapy based on standard clinical assessments didn’t really need to undergo the challenging treatment.
List of related literature:
Screening for mutations in these genes can provide a risk-alerting system for breast and ovarian cancer.
Therefore, most family history clinics have been offering such testing to patients who have high-risk features, such as early-onset breast cancers or a family history consistent with germline mutations.
from Journal of the National Cancer Institute: JNCI. by National Cancer Institute (U.S.), National Institutes of Health (U.S.) U.S. Department of Health, Education, and Welfare, Public Health Service, National Institutes of Health, 2010
The genetic test is positive for gene BRCA1, and her risk of breast cancer is significantly higher thanfor other women who do not have this gene.
Widespread screening for BRCA1 or BRCA2, inherited mutations that increase the risk for breast cancer, is not recommended, but women with a suggestive family history (multiple first-degree relatives with breast or ovarian cancer) should be referred for genetic counseling.
A second type of presymptomatic genetic testing, predispositional genetic testing, is exemplified by testing for BRCA1 and BRCA2, the genes linked to breast and ovarian cancer.
In effect, Liu and coworkers have directly observed the putative BRCA1 tumor progenitor cell, which bears the same ER-negative basal phenotype as the breast cancers that arise from it.
The negative genetic test simply removes the risk for less than 10 percent of breast cancers—those involving the known inherited genetic predisposition.
Susceptibility testing is performed for hereditary can– cer syndromes, such as hereditary breast and ovarian cancer caused by mutations in the breast cancer genes BRCA1 or BRCA2.
Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.
What do you do when your oncologist lies about your condition, uses a medication way too powerful, and an extra experimental drug that made him tons of money. Then he continued treatment when he knew there were majorside effects. I have been in constant, crippling pain for 5 1/2 years. Had I not stopped treatment on my own I would be dead now. Somedays I rhink it would be preferable. There is NO accountability. I was told by several lawyers that he was untouchable, unaccountable for destroying my health and life, because I was given “A cancer drug” and I took it.
I knew this 12 years ago when I looked into French studies and did not have chemo or radiation and I am fine!I would never take chemo that has not been genetically tested and proven to fight my particular cancer. Too many unscrupulous doctors (who make money from chemo use) will give a patient a chemo drug that has already been proven ineffectual for a given cancer but makes them good money! Chris beat cancer has a video with a very experienced oncology nurse that lists the best steps and tests to take before deciding on treatment and alternatives. With the odds most of us have today it is important to do the research way before you might be diagnosed and keep up to date too!
Never in a million years would I destroy my immune system with chemo they better target my cancer with a virus so my body knows to fight it off and kill it
What do you do when your oncologist lies about your condition, uses a medication way too powerful, and an extra experimental drug that made him tons of money. Then he continued treatment when he knew there were majorside effects. I have been in constant, crippling pain for 5 1/2 years. Had I not stopped treatment on my own I would be dead now. Somedays I rhink it would be preferable. There is NO accountability. I was told by several lawyers that he was untouchable, unaccountable for destroying my health and life, because I was given “A cancer drug” and I took it.
I knew this 12 years ago when I looked into French studies and did not have chemo or radiation and I am fine!I would never take chemo that has not been genetically tested and proven to fight my particular cancer. Too many unscrupulous doctors (who make money from chemo use) will give a patient a chemo drug that has already been proven ineffectual for a given cancer but makes them good money! Chris beat cancer has a video with a very experienced oncology nurse that lists the best steps and tests to take before deciding on treatment and alternatives. With the odds most of us have today it is important to do the research way before you might be diagnosed and keep up to date too!
Never in a million years would I destroy my immune system with chemo they better target my cancer with a virus so my body knows to fight it off and kill it