Preventing Unnecessary Chemotherapy after Surgery for Early Breast Cancer

May, 2024

Chemotherapy is a common treatment option for individuals with early breast cancer, but it often comes with significant side effects. However, recent developments in tumour profiling tests may offer a solution to this dilemma. The National Institute for Health and Care Excellence (NICE) has recommended the use of tumour profiling tests to provide valuable information on the genetic makeup of breast cancer tumours. These tests can help guide the treatment of individuals with specific types of breast cancer, potentially reducing the number of people who undergo unnecessary chemotherapy after surgery.

Tumour profiling tests, such as EndoPredict, Prosigna, and Oncotype DX, provide a risk profile of an individual’s breast cancer based on their genetic makeup. This information can be combined with other factors, such as tumour size, to better predict the risk of disease recurrence in the future. The results of these tests are returned in a matter of days, allowing healthcare professionals to make informed decisions about post-surgery treatment options.

Currently, decisions regarding chemotherapy after surgery for individuals with breast cancer that has spread to 1 to 3 lymph nodes are made based on various factors. These include the specific characteristics of the cancer, the risk of recurrence, and the preference of the individual with cancer. However, tumour profiling tests can provide additional information that may be helpful in making these decisions. If the test results indicate a low risk of cancer recurrence, individuals may feel more comfortable opting out of chemotherapy. This could potentially spare them from the harmful side effects associated with the treatment.

One of the key benefits of tumour profiling tests is their ability to predict the risk of cancer coming back in a different part of the body. Additionally, the Oncotype DX test can help clinicians identify individuals who are less likely to benefit from chemotherapy after surgery. This means that those who are unlikely to benefit from chemotherapy can avoid undergoing the treatment altogether, reducing the likelihood of unnecessary side effects.

Mark Chapman, interim director of the Health Technologies Programme at NICE, emphasizes the significance of these tests for patients. He acknowledges that choosing whether to undergo chemotherapy is a challenging decision, especially when individuals do not have all the necessary information. Therefore, a test that can help predict the risk of breast cancer spreading is considered a significant step forward. Chapman also highlights the emotional and psychological strain individuals face when making this decision. With the availability of tumour profiling tests, some individuals can make more informed choices, potentially sparing themselves from the side effects associated with chemotherapy.

The recommendation by NICE reinforces their commitment to providing the best innovative care based on evidence while ensuring value for money for the taxpayer. Tumour profiling tests have already been recommended by NICE for guiding chemotherapy decisions in individuals with specific types of breast cancer. The recent recommendation expands the use of these tests to women who have been through menopause, as well as men, with certain types of early breast cancer.

Breast cancer is the most common cancer in the UK, affecting approximately 1 in 7 women during their lifetime. In 2020, there were 44,943 new cases of breast cancer diagnosed in women in England alone, with the majority of cases occurring in women over the age of 50. These statistics highlight the importance of finding more targeted and personalized treatment options for individuals with breast cancer.

In conclusion, tumour profiling tests have the potential to revolutionize the treatment of early breast cancer. By providing valuable genetic information, these tests can help healthcare professionals make more informed decisions regarding post-surgery treatment options. This can lead to a reduction in the number of individuals who undergo unnecessary chemotherapy, sparing them from the side effects associated with the treatment. The recommendation by NICE further supports the use of these tests, ensuring that patients receive the best possible care based on evidence and value for money for the taxpayer. As we continue to advance in the field of personalized medicine, tumour profiling tests offer hope for a future where treatment decisions are tailored to patients, improving outcomes and quality of life for those affected by breast cancer.




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About the Author

  • Dilruwan Herath

    Dilruwan Herath is a British infectious disease physician and pharmaceutical medical executive with over 25 years of experience. As a doctor, he specialized in infectious diseases and immunology, developing a resolute focus on public health impact. Throughout his career, Dr. Herath has held several senior medical leadership roles in large global pharmaceutical companies, leading transformative clinical changes and ensuring access to innovative medicines. Currently, he serves as an expert member for the Faculty of Pharmaceutical Medicine on it Infectious Disease Commitee and continues advising life sciences companies. When not practicing medicine, Dr. Herath enjoys painting landscapes, motorsports, computer programming, and spending time with his young family. He maintains an avid interest in science and technology. He is a founder of DarkDrug

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