Many Breast Cancer Patients May Not Need Chemotherapy

Many Breast Cancer Patients May Not Need Chemotherapy

Even after two years, she is still cancer-free.

Being able to avoid chemotherapy would be a blessing for thousands of women with breast cancer.

A promising experimental treatment has left a Florida woman's advanced breast cancer in remission.

Across the European Union, we have seen positive results for breast cancer care as more women are being diagnosed and treated earlier, leading to higher survival rates.

Dr. Lisa Carey, a breast specialist at the University of North Carolina's Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it.

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Researchers at the National Cancer Institute (NCI) examined over 10,000 breast cancer patients and found that women who were treated with an estrogen-blocking hormone therapy had a almost identical survival rate to women treated with chemo and hormone therapy.

The charity Breast Cancer Now said the findings were "practice-changing". It showed most patients with an intermediate risk of cancer recurrence can avoid chemotherapy without hurting their chances of beating the disease.

Another study at the conference found that Merck's immunotherapy drug Keytruda worked better than chemo as initial treatment for most people with the most common type of lung cancer, and with far fewer side effects.

The TAILORx study, led by the Montefiore Medical Centre in NY, found women older than 50 with this form of breast cancer and a score of up to 25 did not need chemotherapy. "We want to give the right amount", he said.

The largest breast cancer trial ever conducted has yielded surprising results: Thousands of women can potentially skip grueling chemotherapy when it comes to treating early-stage breast cancer. Oncotype DX has spurred the trend, and is likely to accelerate it.

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The findings will lead to a "fundamental change" in the way the disease is treated, a leading oncologist said, with an estimated 3,000 to 5,000 United Kingdom women likely to avoid chemotherapy every year as a result.

According to the American Cancer Society, one in eight women will develop breast cancer in her life.

Patients, aged 18 to 75, were randomly assigned to receive chemotherapy followed by hormonal therapy or hormone therapy alone. The side effects are often harsh and debilitating.

"The 9-year rate of distant recurrence in women with a recurrence score of 11 to 25 in our trial was approximately 5%, irrespective of chemotherapy use", the authors write. The disease returned 10 years later, creating tumours throughout her liver and chest. While lymph nodes in the axilla (armpit) are the most commonly affected, and are usually treated with surgery or radiation, the cancer may spread into lymph nodes behind the breast bone - called internal mammary (IM) lymph nodes - and then to those above the collar bone - called medial supraclavicular (MS) lymph nodes.

The overall survival rate was similar: 93.9% for those who received hormone therapy alone and 93.8% for those who received both therapies. Exploratory analyses did suggest that the addition of chemotherapy was associated with some benefit for women 50 years of age or younger who had a recurrence score of 16 to 25, but not for those whose score 15 or lower.

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"This study gives us information on a very specific group of women with a very specific type of cancer", she said, "but it doesn't tell us chemotherapy is not effective in some cases". That doctors and researchers need to constantly re-evaluate the assumptions on which medical decisions are based, especially for something as important and time-sensitive as cancer treatments.

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