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Effectiveness & Impact of a Multigene Breast Cancer Test

Posted Jan 13 2010 12:00am
Two new studies published in the Journal of Clinical Oncology examined the effectiveness of a 21-gene test for predicting locoregional breast cancer recurrence and the impact the results of this test have on physicians and patients regarding breast cancer treatment options.

In the first study, breast cancer researchers investigated the association between the multigene test's recurrence score and the 10-year risk for locoregional return of breast cancer in patients with node-negative (lymph nodes not involved), estrogen receptor - positive breast cancer.  The results showed a close relationship between the recurrence score and risk for breast cancer recurrence in breast cancer patients treated with tamoxifen:
  • Patients with a low recurrence score had a 4.3% estimated risk of breast cancer recurrence.
  • Patients with an intermediate recurrence score had a 7.2% estimated risk of breast cancer recurrence.
  • Patients with a high recurrence score had a 16% estimated risk of breast cancer recurrence.
Similar relationships between the recurrence score and risk of breast cancer recurrence were observed in placebo-treated patients and in breast cancer patients treated with tamoxifen + chemotherapy.

In the second study, breast cancer researchers examined the impact of the 21-gene recurrence score on physician and patient treatment selection and satisfaction.  For this study, physicians were asked to recommend an appropriate breast cancer therapy and their confidence in it both before and after conducting the 21-gene test.  The results were rather dramatic:
  • Physicians changed their treatment recommendation for 31.5% of the breast cancer patients after seeing the recurrence scores from the 21-gene test.
  • 27% of patients altered their treatment decision after seeing their recurrence scores.
  • In nearly 23% of the cases, physicians changed treatment recommendation from hormone therapy + chemotherapy to just hormone therapy, since chemotherapy is generally not recommended for breast cancer patients with low scores.
  • Physician's confidence in their treatment recommendation improved in 76% of cases, while patient anxiety regarding treatment decisions was improved after seeing their recurrence scores.
This is important research that can very possibly impact breast cancer therapy, at least in estrogen receptor - positive breast cancer patients, which make up the majority of breast cancer patients.  These results indicate that this 21-gene test does a good job of determining the risk of breast cancer returning and can guide breast cancer therapy choices based on the score.  Women with a low recurrence score in this test, might well be able to avoid chemotherapy.  These results continue to show a move toward personalized medicine where treatment decisions are based on an individual's personal risk factors.  To learn more about this 21-gene test, visit their website.

While personlization of medicine continues to make great strides, we can all make personal decisions to help lower our risk of getting breast cancer.  My book, Fight Now: Eat & Live Proactively Against Breast Cancer (www.fightBCnow.com), discusses many of the diet and lifestyle changes you can make to help fight breast cancer. 
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