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Some women with breast cancer may not need chemotherapy


John Erban, MD is an oncologist at Tufts Medical Center.Findings from a major international study published in the New England Journal of Medicine earlier this month have revolutionized the way oncologists think about cancer treatment. Researchers found that many women with early-stage breast cancer who would typically receive chemotherapy actually don’t need it.

“It’s truly a game changer,” John Erban, MD, Clinical Director of the Cancer Center at Tufts Medical Center told NBC Boston. “It really allows women the promise of precision medicine.”

Through gene tests on tumor samples, researchers were able to identify women who could safely skip chemotherapy. These women were then placed on a regime of hormone therapy and achieved the same results as those who went through hormone therapy plus chemotherapy, but without the hair loss, nausea and other debilitating side effects caused by the toxic treatment.

“Now we have a tool that can help identify the individual who will benefit and separate that woman from the women who will not benefit from chemotherapy,” Dr. Erban said. “The risk of important side effects like cardiac toxicity and nerve injury can be reduced or eliminated if we simply don’t need to use the chemotherapy.”

The gene test, called Oncotype DX Breast Cancer Assay, is generally done on women with early-stage disease and is performed on tumor samples to help determine whether or not chemotherapy is needed.

The test gives a score from 0 to 100. Typically, scores between 0 and 10 indicate that there is not a benefit from chemotherapy while scores above 25 indicate that there may be a benefit from chemotherapy. Women with scores between 11 and 25 were left in a grey area, but the majority of them still received chemotherapy. Now, with the knowledge gained from the TAILORx study, oncologists can safely spare many women in that range from having to consider chemotherapy without compromising their health.

Patients should check with their physicians on how to interpret these important new results.