Cell check spares women chemo for breast cancer
BREAST cancer patients may be spared chemotherapy thanks to new tests that pinpoint genetic ‘markers’ in the tumour and determine its aggressiveness.
After surgery, the cancer cells are sent to a lab where they are screened, and women can be told within days whether they have a high or low risk of the disease returning. For some women, the test can accurately tell if the risk is as low as five per cent, which is as good as if not better than the odds for those who have chemotherapy.
The majority of women who have breast cancer are routinely given the gruelling drug treatment following removal of the tumour to prevent recurrence. Although the medication kills off cancer cells, the side effects – including complete hair loss, nausea, sickness, weight gain or loss, and extreme fatigue – can be difficult to live with. For some women, the prospect of chemotherapy is more daunting than the surgery itself. But experts have long-believed that the risk of cancer recurrence for certain women is a lot less than for others, and that for some, chemotherapy may not be necessary.
If the newest of the tests, called Endo Predict, shows a low score, patients can opt not to have chemotherapy.
Most of the tests are available only privately and cost about £2,500, although breast specialists hope they may soon become properly available on the NHS.
Surgeon Hemant Singhal said: ‘I think there is a good case for the NHS to use this test on the basis that the cost is balanced out by savings in not giving chemotherapy.’
Professor Kefah Mokbel, consultant breast surgeon at St George’s Hospital, London, said: ‘With this test we can help patients make an informed choice, whereas in the past we have just given chemotherapy to almost everyone.’
Becca Cornford, a 49-year-old mother of three aged 11, six and four, was recovering from being diagnosed and treated for breast cancer last year only to then discover that she had cancer in her other breast.
She said: ‘I dreaded chemo more than another mastectomy. I was worried it would interfere with me being able to look after my children.’
Professor Mokbel operated on Becca in December at the Princess Grace Hospital, London, and afterwards a sample of her tumour was sent away and tested using the Endo Predict.
A low score meant her chances of recurrence within ten years were just five per cent and she was told chemotherapy could not offer much better odds. ‘I could have gone through chemo and the cancer could still return,’ she says.
‘There is no treatment that places your chances at zero. But if you have regular monitoring, there is every chance that any cancer that might come back would be nipped in the bud early.’