Headline November 02, 2016/ ''' WRETCHED -*BREAST*- CANCER- '''

''' WRETCHED -*BREAST*- CANCER- '''

GENE ACTIVITY DETERMINES  -if breast cancer patients can avoid toxic treatment.

So, -when is it safe for women with breast cancer to skip chemotherapy?

*A new study helps answer that question, based on a test of gene activity in tumors*. 

It found that nearly half of women with early-stage breast cancer who would traditionally receive  chemo  can avoid it, with little risk of the cancer coming back or spreading in the next five years.

The so-called genomic test measures the activity of the genes that control the growth and spread of cancer, and can identify women with a low-risk of recurrence and therefore little to gain from chemo.

''More and more evidence is mounting that there is a substantial number of women with breast cancer who will not need chemotherapy to do well.'' said Dr. Rachel A. Freedman, a breast cancer  oncologist at the Dana-Farber Cancer Institute in Boston. She was not involved in the study.

The researchers estimated that their findings, published recently in The New England Journal of Medicine, would apply to  35,000 to 40,000 women a year in the United States-

And  60,000 to 70,000  in Europe. They are patients with early disease who would normally be prescribed  chemo  because of tumor size, cancerous lymph nodes and other factors.

Genomic tests, which doctors have been using for about 10 years in some breast cancer patients, are part of a growing effort to spare women from chemo and its harsh side effects whenever it is safe to do so.

But the decision to forgo a potentially lifesaving treatment is never taken lightly, and doctors have been eager for more data to make sure they are on the right path.

The new study is one of the largest and most rigorous trials of genomic testing, and it offers reassurance to doctors and patients that the technology can be trusted to help identify patients who do not need chemo.

But an editorial accompanying the report said the study was not the final word, and additional research now under-way would provide more clarity.

Although women who skipped chemo had low recurrence rates, their rates were slightly higher than those of women who had chemo.

A test called  Onetype  DX  is widely used in the United States. The new study used another, called  MammalPrint , which is used less often. The tests cost several thousand dollars, and insurance coverage varies.

Dr. Kathryn J. Ruddy, a breast cancer specialist at the Mayo clinic in Rochester, Minn, who was not part of the research, said in an email that the study was important because: ''it will help more patients avoid the toxicities of chemotherapy 

{potentially including permanent nerve damage, heart failure and leukemia}.'' 

The risks from certain types of chemo increase with the patient's age. the risk of leukemia is about  0.5 percent to 1 percent, and the heart risk can reach 4 percent or 5 percent in older women, Dr. Freedman said.

The study involved women with  early cases of the most common type of breast cancer:

hormone-sensitive tumors that test negative for a receptor called her2.

In the United States, about three quarters are of that type.

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''' Toxic Treatment '''

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