Women with breast cancer must not only deal with the challenges of a potentially life-threatening disease; they also have to face the challenges of breast cancer treatment.
Chemotherapy is an essential mainstay for many who require breast cancer treatment, but it causes side effects that are at best unpleasant and at worst, toxic.
And in addition to potentially serious side effects, the hair loss that often follows is particularly upsetting for many.
Now all that may be changing for a large number of women with early stage breast cancer, and chemo may be unnecessary for a large percentage of women diagnosed with breast cancer.
The study reported in the New England Journal of Medicine was based on a 21-gene breast cancer assay that predicts if a woman is at high or at low risk of recurrence if she doesn’t receive chemotherapy.
It’s known that if the results of the assay are low (1-10 out of a total score of 100) don’t need chemo, and if the results are high (26+ out of 100) they do. But what about women with midrange scores of 11-25?
In this study of 10,273 women 69% had a midrange score. So half received chemo and half did not. Both groups would still have to take tamoxifen, an anti-estrogen hormone.
The results reported that the women with a midrange score who took the hormone therapy tamoxifen did equally well whether or not they also received the addition of chemotherapy. The study was called The Trial Assigning Individualized Options for Treatment (TAILORx).
But it still isn’t entirely black and white. Women who were under age 50 still may benefit from the addition of chemo even if they are in the midrange for the assay. And that continues to put them at risk for early menopause due to the effects of the chemo on their ovaries.
The good news is that breast cancer continues to be a disease that has a high chance of being cured. And now, for a larger number of women may be able to be cured without taking potentially toxic chemotherapy.
More studies are underway to determine if the under 50 group can avoid the chemotherapy. For them, this sea change may still take a while to see change for breast cancer treatment.