Most Women with Early Breast Cancer Can Forgo Chemotherapy, Large Trial Finds

Most Women with Early Breast Cancer Can Forgo Chemotherapy, Large Trial Finds
Seventy percent of women with the most common form of early breast cancer can avoid chemotherapy after surgery, according to a landmark Phase 3 clinical trial. The trial’s results, “Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer,” were published in the New England Journal of Medicine. Women with early stage breast cancer long have been treated with aggressive therapies, such as chemotherapy, in addition to hormone therapy. But in the past few years, many researchers have come to understand that not all patients benefit from chemotherapy. The development of Oncotype DX Breast Recurrence Score test has changed the standard of care for many breast cancer patients. The test consists of a tumor biopsy that looks at 21 tumor genes associated with a high likelihood of recurrence, giving it a score from one to 100 for its risk of spreading elsewhere and returning. In 2004, a study called NSABP B-20 showed this test could successfully predict not only cancer recurrence,  but also the benefit from adjuvant chemotherapy in women with early-stage breast cancer. Women with low recurrence scores (0-10) showed little to no benefit from chemotherapy, while those with high recurrence scores (26 or more) clearly benefited from it. Since then, women with a low score typically receive hormone therapy alone and those with a high score receive hormone the
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