Chemotherapy or No Chemotherapy in Breast Cancer

Chemotherapy or No Chemotherapy in Breast Cancer


Chemotherapy or no chemotherapy – it’s a
big question in cancer care especially when it comes to breast cancer. New
findings announced this year show many women they can confidently skip chemo. A landmark clinical trial – TAILORx – definitively reinforcing what many
oncologists have believed, that chemotherapy is not what every breast
cancer patient needs. “A very large number of women all of whom used to get
chemotherapy can now be spared the side-effects and recognize that it just
wouldn’t do them any good.” Dr. Eric Winer, chief of Dana-Farber Cancer Institute’s
breast oncology program, says it comes down to the patient’s type of breast
cancer and specific tumor score using a molecular test. The trial gave doctors
some specific information regarding chemo treatment. “These were all women who
had estrogen receptor positive breast cancer where the lymph nodes were
negative as well.” The trial sampled more than 10,000 tumors. Each tumor was given
a score. Low scores received hormonal therapy but no chemotherapy with
phenomenal outcomes. High scores received both hormonal therapy and chemotherapy.
The middle scores received hormonal therapy but were randomly assigned
chemotherapy and the result – there was little statistical difference in
long-term outcomes. “In women over the age of 50 there’s no question that there was
no benefit from chemotherapy if the tumor score was between 11 and 25.” It’s
all about giving each woman the treatment she needs. The vast majority of
these patients can now avoid the risks associated with chemotherapy and Dr.
Winer says there’s another big advantage. “For the women who really are at risk it
allows us to focus on them and focus research questions on them that really
shouldn’t be focused on the larger group.” For women younger than 50 in that mid
range there might still be some benefit to chemotherapy so Dr. Winer says it is
always important to have these discussions with your doctor. For Dana-
Farber Cancer Institute, I’m Victoria Warren.

3 comments

  1. Link to the actual study, for anyone who is interested: www.nejm.org/doi/pdf/10.1056/NEJMoa1804710
    It is not behind a pay wall.

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