Gene test shows which breast cancer patients can skip chemo

Many women with early-stage breast cancer can skip chemotherapy without hurting their odds of beating the disease - good news from a major study that shows the value of a gene-activity test to gauge each patient’s risk. The test accurately identified a group of women whose cancers are most likely to respond to hormone-blocking drugs that adding chemo would do little if any good while exposing them to side effects and other health risks. In the study, women who skipped chemo based on the test had less than a 1% chance of cancer recurring far away, such as the liver or lungs, within the next five years.

I was convinced that there was no indication for chemotherapy. I was thrilled not to have to have it.

Dr. Karen Beckerman, a New York City obstetrician diagnosed with breast cancer in 2011

But many women also are urged to have chemo, to help kill any stray cancer cells that may have spread beyond the breast and could seed a new cancer later. Doctors know that most of these women don’t need chemo but there are no great ways to tell who can safely skip it. Mary Lou Smith, a breast cancer survivor and advocate who helped design the trial for ECOG, the Eastern Cooperative Oncology Group, which ran it, said she thought women “would be thrilled” to skip chemo.

These patients who had low risk scores by Oncotype did extraordinarily well at five years.

Dr. Hope Rugo, a breast cancer specialist at the University of California