New Genetic Test Could Save Some Women With Breast Cancer From Chemotherapy

New Genetic Test Could Save Some Women With Breast Cancer From Chemotherapy
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Rui Vieira/PA Wire

A new genetic test could save more women with breast cancer from having to go through chemotherapy.

The EndoPredict test, which takes just a few days, can accurately predict if a woman’s cancer is likely to spread around the body.

Doctors would be able to see the genetic make-up of a tumour giving them a clearer indication of how the cancer would develop over the next 10 years.

What makes EndoPredict particularly advantageous over the current service offered on the NHS is its speed.

The current test Oncotype DX takes 14 days and has to be sent over the US for analysis. EndoPredict on the other hand takes just a few days and can be done here in the UK.

This information can be used to inform personalised treatment decisions by identifying which patients would be most likely to benefit from treatment with chemotherapy after surgery and those who won’t need it, thereby avoiding unnecessary side-effects.

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Both tests are for women with oestrogen receptor positive, HER2 negative (ER+/HER2-) disease, which accounts for around two-thirds of all breast cancers.

More than 33,000 women are diagnosed with ER+/HER2- breast cancer each year in the UK.

By identifying those at low risk of their disease spreading, women who would see little benefit from chemotherapy could be spared its gruelling side-effects.

The study - led by researchers at the Institute of Cancer Research in London and the Royal Marsden NHS Foundation Trust in collaboration with Queen Mary University of London, and published on Monday in the Journal of the National Cancer Institute - compared the performance of EndoPredict and Oncotype DX.

A woman’s risk of her cancer spreading is calculated using the results from the genetic test combined with the size of her tumour and whether disease has spread to the lymph nodes.

Women are classed as low risk if they have less than a 10% decade-long risk of their cancer spreading.

In the study, just 5.8% of all patients identified as low risk by EndoPredict went on to see their cancer spread over a decade compared with 10.1% of patients identified as low risk by Oncotype DX.

Study lead author Dr Richard Buus, from the Institute of Cancer Research, London, said: “This study showed that a new test is more accurate than the current NHS standard test at detecting women at lowest risk of their breast cancer spreading to other parts of the body in the long-term.

“It could help improve treatment for a large number of women with breast cancer by allowing doctors to better predict which women are least likely to go on to develop secondary cancer – and could therefore be spared from undergoing the chemotherapy often offered early on in treatment to reduce that risk.”

Baroness Delyth Morgan, chief executive of Breast Cancer Now, said: “This important study demonstrates the exciting potential of EndoPredict to identify breast cancer patients that will benefit little from chemotherapy. This test could give patients and their doctors invaluable reassurance that they may safely be spared chemotherapy’s gruelling side-effects.

“Oncotype DX remains a valuable tool for both clinicians and patients. But we need to see the best and most cost-effective technologies made routinely available on the NHS, and this research suggests EndoPredict could be another step forward.

“Based on this strong evidence, we would encourage the National Institute for Health and Care Excellence (Nice) to consider this technology for routine use on the NHS.”

Breast Cancer Signs And Treatment
What Are The Symptoms?(01 of10)
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"A new painless, firm breast lump with irregular margins is a potential symptom of breast cancer," says Dr. Sandhya Pruthi, a breast cancer researcher at the Mayo Clinic. "The cancer diagnosis is confirmed following a biopsy of the lump." She notes that usually, women who are newly diagnosed with breast cancer are healthy and don't feel sick at all. (credit:LarsZahnerPhotography via Getty Images)
Other Symptoms(02 of10)
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Another potential symptom/sign of breast cancer, Pruthi notes, is a new onset of persistent redness on the skin overtop the breast with an orange peel appearance. This would also need a biopsy to confirm a diagnosis of breast cancer. (credit:Image Source via Getty Images)
Metastatic Cancer Symptoms(03 of10)
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"If the cancer is very advanced (metastatic) then the symptoms may also include weight loss, bone pain, headaches, nausea and persistent cough," Pruthi says. (credit:pamela burley via Getty Images)
What Are The Risk Factors?(04 of10)
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Some commonly associated risk factors, Pruthi says, are menstruation before age 11, menstruation after age 54, a first pregnancy after age 35 and a family history of relatives diagnosed with breast or ovarian cancer. (credit:AP Photo/M. Spencer Green)
Are There Any Lifestyle Risk Factors?(05 of10)
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"There is evidence in the literature that obesity after menopause, lack of regular exercise, consuming greater than more or more alcoholic beverages daily, and a high fat diet can all be associated with a higher breast cancer risk," Pruthi notes. But, she points out, "women need to know that any woman can get breast cancer even in the absence of any of these risk factors." (credit:Adrian Samson via Getty Images)
Can I Eat Anything To Prevent It?(06 of10)
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There are no specific types of diets, Pruthi says, but rather women are encouraged to eat fruits, vegetables, fibre, and minimize their alcohol and fat intake, as well as get regular exercise. (credit:lola1960 via Getty Images)
How Do Doctors Determine Treatment?(07 of10)
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"The most current treatment of breast cancer has taken on a individualized approach and is dependent on the biology or aggressive features of the breast cancer," Pruthi explains. "Breast cancer is a heterogeneous disease and this means that are many sub-types and different degrees of aggressiveness. So staging, which typically takes into account common prognostic features such as tumour size and if lymph nodes are involved, are no longer the only factors doctors use to determine treatment options." (credit:Christopher Futcher via Getty Images)
So What Do They Look At?(08 of10)
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"Today the biology of the tumour is also characterized by molecular markers (also known as predictive markers) such as if the estrogen or progesterone receptor is positive or negative and if the HER 2 protein is positive or negative," she says. "This helps decide who will benefit from a specific chemotherapy regimen, hormonal medications known as antiestrogens or who may need both chemotherapy and hormonal treatment." (credit:BluePlanetEarth via Getty Images)
What About Preventative Mastectomies?(09 of10)
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"Preventive mastectomy is an option for women at very high risk for developing breast cancer because they are BRCA 1 or 2 gene positive or if someone has hereditary predisposition to getting breast cancer but chooses not to have the genetic testing done," Pruthi says. "It is prudent that women who are considering this surgery know their family history in detail. Based on the moderate or strong family history, your doctor would recommend you meet with a genetic counselor to go over the family pedigree and help decide who should test for the breast cancer gene, when to test and how to interpret the genetic test results before proceeding with this preventive surgery." (credit:Jesús Jaime Mota via Getty Images)
Are Other Preventative Treatments Available?(10 of10)
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"High risk women who have had precancerous breast biopsies or strong family history may also be eligible to take preventive medications such as tamoxifen, raloxifene or exemestane to reduce breast cancer risk," Pruthi adds. (credit:art-4-art via Getty Images)