Test could spare 6,000 breast cancer patients from chemotherapy by telling doctors the genetic make-up of their tumour and how likely it is to return
- A new trial suggests breast cancer sufferers could go without chemotherapy
- The treatment is typically used after surgery to stop the cancer from returning
- But a new test could tell medics which women need the powerful treatment
Using a genetic test could tell doctors which breast cancer sufferers need the powerful treatment (stock photo)
Thousands of women with breast cancer could be spared the gruelling ordeal of chemotherapy, a trial suggests.
Using a genetic test could tell doctors which women need the powerful treatment, and which women could be safely spared its harsh side effects.
Chemotherapy is commonly used after surgery to stop breast cancer returning.
But by analysing the genetic make-up of the tumour, scientists can now calculate the likelihood of the cancer returning, allowing them to identify women at low-risk.
A trial led by experts at the University Hospital of South Manchester suggests 63 per cent of women with the most common form of breast cancer could avoid chemotherapy by using a genetic test called Oncotype DX. Up to 6,000 a year in Britain could avoid the need for chemotherapy if the test was widely used, the results suggest.
Professor Nigel Bundred, the breast cancer surgeon who led the trial, said: 'Deciding whether to have chemotherapy is a big decision for women in this position to make.
'Their life is on hold for six months while the treatment is completed, they may lose their hair and there is fatigue and other side effects.
'But they are also deciding about the risk of recurrence – it is a decision they will have to live with for the next five or ten years of their life. This test helps give women more certainty about their decision.' NHS watchdog NICE issued guidance approving use of the Oncotype DX test in September 2013.
But since then only 9,200 women have been given the test – fewer than 3,000 a year. Experts hope the new findings, published in the European Journal of Surgical Oncology, will see wider use of the test. One reason for low take-up is thought to be the price of the test – £2,580 minus a confidential NHS discount.
But scientists stress this is dwarfed by the price of unnecessary chemotherapy, which costs the NHS an average of £6,180 per patient. The researchers used the test on 201 women at the Wythenshawe and Christie Hospitals in Manchester who had been diagnosed with an early stage of ER positive HER2 negative breast cancer – the most common form.
Each had had surgery to remove the tumour, and was being considered for chemotherapy.
Chemotherapy (stock photo) is commonly used after surgery to stop breast cancer returning
The test analyses samples of the tumour taken during surgery. After using the test, 63 per cent of women were advised they would not have to have chemotherapy – advice that was accepted by 98 per cent.
This included 60 per cent whose breast cancer had not yet spread to their lymph nodes – the group for whom NICE already recommends the test.
But the scientists found that chemotherapy could also be avoided in 69 per cent of women who already had cancerous cells in the lymph nodes, which suggests use of the test could be extended. Breast cancer is Britain's most common cancer, with 55,000 women diagnosed with the disease each year, 43,000 of whom have surgery to remove their tumour.
About 41 per cent of these women – roughly 18,000 a year – receive chemotherapy to reduce the risk of early-stage breast cancer returning after surgery, with the powerful drugs destroying any microscopic cancer cells that have escaped the surgeon's knife.
But chemotherapy can cause gruelling side effects including nausea, hair loss and exhaustion.
The test could be used for about half of these women – those with the ER positive HER2 negative form. If the Manchester results were replicated nationally, roughly 6,000 women in Britain could avoid chemotherapy every year.
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