Multigene Testing for Breast Cancer May Help Patients Avoid Chemotherapy

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A study reported in the Journal of Clinical Oncology noted that a 21-gene test that predicts whether early breast cancer patients will benefit from chemotherapy is influencing the decision for type of treatment ordered by physicians and patients. In their study the researchers reported that as a result of the test the physicians changed their treatment plan for 31.5 % of the cases, and patients changed their treatment plan 31.5% of the time.
The multigenetic test, Oncotype DX, examines 21 genes from a tumor sample to determine how active they are. A test score between 0 and 100 predicts the likelihood of the cancer recurring. If women have a low score, chemotherapy is not recommended. Since the test became available in 2004 (for patients with estrogen recepton-positive breast cancer that has not spread to the lymph nodes) , over 120,000 breast cancer patients have undergone the test. There are about 100,000 cases of breast cancer that fall within this category yearly.
This study looked at 89 breast cancer patients who received the gene test. They were treated by 17 medical oncologists. Doctors changed decisions for 28 patients and in 20 of these they changed from hormone therapy plus chemotherapy to hormone therapy alone. Twenty-four patients changed their decisions including 9 who dropped chemotherapy. Doctors reported the test increased their confidence in their treatment decision in 76% of the patients. The cost of the test is $3,910 and most insurance plans will cover it.

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