(applause) About one in eight women will develop breast cancer over the course of their lifetime. But a breakthrough study may help women navigate this life changing diagnosis. The study found that many women with early stage breast cancer can avoid chemotherapy. These findings, of course, could change the treatment for as many as 70 000 women per year here in the US. Joining us now to discuss, via Skype, is breast surgeon, our good friend, Dr. Kristi Funk. (applause) Dr. Funk Kristi, how are ya? Hey guys, I’m well. Good to be here. So glad to have you back on and I know, in your profession, you get so excited when new research comes out, changes the way you treat women, particularly when it’s good news. Tell us about this study and what it means. Travis, we’ve been waiting twelve years for this study to come out and it is groundbreaking. So, as you mentioned in the opener, 70 000 women will avoid having to endure chemotherapy as part of their cure because we know their prognosis is so excellent that chemotherapy can’t make a great thing even better. This is so life changing. So the women that this applies to is no small number. 50 percent of all invasive breast cancers worldwide apply to these criteria. And you need a cancer under five centimeters, with lymph nodes negative, meaning they’re clear of tumor, estrogen driven and not driven by HER2. So, of all of these women, you take those cancers and you put them into this assay, this gene analysis called Oncotype DX. And what that does is it looks at a bunch of tumor markers that are either good genes to express or bad genes, and depending on your personal cancer’s fingerprint, it spits out the percent chance that your cancer will come back again in 10 years or less in a metastatic, life-threatening place, like lung, liver, brain, bone. If that number is high, then you should do chemo, because that can make the high number lower. If it’s low, you know that you don’t need chemo. But we’ve known that since 2004. What this study did is it took the 70% of women that landed in the middle ground. That was a ton, over 6700 women in this study, were in the intermediate group. Like, I don’t know, maybe you should do chemo. You probably should do chemo. Well, they took that 6700 women, divided them in half. Half got chemo, half didn’t. It’s been nine years. We now know that none of them will benefit from chemo, except a small subset, women under 50 in the high end of that middle range. So, 70 000 women a year (applause) Fantastic So, Kristi, let’s say one of our viewers has a new breast cancer diagnosis. How do they broach this conversation with their provider. Like, how do you start out and where do you go with this information. So, when you’re newly diagnosed, you won’t know a hundred percent if you meet these criteria for the Oncotype DX because you don’t have proof positive evidence that your lymph nodes are clear or negative until you have your surgery. So, after your surgery, again if your cancer ends up in the final analysis being under five centimeters, driven by estrogen, not HER2, and then, your nodes are clear, ask your doctors, well can I do that new gene test on the tumor to find out if I really need chemo because you’re telling me I do because I’m 42 years old and I have three kids, which sounds like I should pull out all the stops and do everything under the sun, but if the genetics of my tumor aren’t going to respond to chemo, and I already have a phenomenal survival rate, wow, I don’t need to like see what my head looks like bald and being nauseated, but more importantly, I don’t want to be subject to heart damage, nerve damage, leukemia down the road. Chemo is no joke, let alone lost work, sick days, child care issues. It’s a huge burden lifted from thousands of women every single year in the world Amazing It’s such great news Well and it… Game changer It really gets back to the way treatment for cancer is changing universally, Dr. Funk, because it’s personalization, it’s looking at you, the individual. Which is so different that even ten, fifteen years ago. So as a breast surgeon, for you, this is such great information. Because I’ve always felt so bad for women when you’ve had to give the advice, Well, you could or you couldn’t, cause, how, I don’t even… That’s really difficult I don’t even, yeah, I don’t even know how you say, Oh, I don’t, I don’t want to or I do. We’re not sure or we have to err on the safe side, you going to get chemo What a tough, tough decision. I’m so excited for this. And I’m curious then so, if people don’t need chemo, what is their treatment regimen going to look like? So, they already had their operation and if they kept their breast, they probably need radiation. If they had a mastectomy, they probably don’t. If they didn’t need the chemo, they probably don’t have criteria for radiation after mastectomy. But all of these women that we’re talking about, have to at least strongly consider taking anti-estrogen therapy. That’s sort of part of the deal. You do the anti-estrogen therapy instead of the chemo and it works equally well.