Proceeds from the U.S. Postal Service's breast cancer stamp put researchers over the top when they were trying to get enough money to do the landmark study published on Sunday that showed genetic testing can reveal which women with early-stage breast cancer need chemo and which do not.
"You take a patient's own cells, you attack their own cancer with their own cells and you attack a unique mutation that's present in their cancer and none others", explained Dr. Steven Rosenberg of the National Cancer Institute. We have known that for a long time.
There has always been suspicion that chemotherapy is overused in treating some forms of cancer-now doctors and patients can make more informed decisions about which cancer treatments they choose and which will be effective. Dr. Jennifer Ashton, ABC News" Chief Medical Correspondent, says, "This is for the woman at intermediate risk for that cancer to reoccur.
About 17 percent of women had high-risk scores and were advised to have chemo. The patient's cancer could not have spread to the lymph nodes.
Oncotype DX first hit the market in 2004. "So we have two yes-no answers for each gene".
The experiment led to "complete durable regression" of the cancer that had spread to Judy Perkins' liver, the team said, writing in the journal Nature Medicine. Most women in this situation don't need treatment beyond surgery and hormone therapy, and "the rest of them are receiving chemotherapy unnecessarily". "They are going to change treatment - and remove uncertainty for women making decisions". In the short term, chemotherapy can cause hair loss, nausea and other digestive issues, serious fatigue, weakness, and brain fog.
Breast cancer is the most common cancer among women in India.
"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.
Under 50s with a score of up to 15 can also be spared the treatment and only receive hormone therapy drugs after surgery, according to the research.
Sparano noted that given the several variations of endocrine therapy now available, women who have trouble tolerating one should try another.
About 41,000 women and 465 men died from the disease that year.
Nine-year survival rates were 93.9% without chemotherapy and 93.8% with chemotherapy, the study found.
Ms Perkins had 62 mutations in her tumour cells. "But we need to be precise on when to use it and who to recommend it to".
This study supports sparing thousands of women from the sometimes nasty side-effects of chemotherapy, but we must be crystal clear that it applies to a very specific (and significant) subset of women.
But there is a note of caution in interpreting the study's findings.
The result: After an average follow-up of 7.5 years, the researchers saw no added benefit in this group to adding chemotherapy to the treatment mix.
Women can have the tendency to turn towards chemo, even if the results have a relatively small benefit, Albain says.
Those women should carefully discuss their options with their oncologist, said Brawley, because they would likely be candidates for the more aggressive, dual therapies. The researchers gave half the women hormone-blocking drugs alone, and half hormone-blocking drugs and chemotherapy.