The study found that for women with hormone receptor (HR)-positive, HER2-negative, axillary lymph node-negative breast cancer, treatment with chemotherapy and hormone therapy after surgery is not more beneficial than treatment with hormone therapy alone.
Dr. David Chang, a pancreatic cancer surgeon from the University of Glasgow and Glasgow Royal Infirmary, said: "The main conclusion from this study is that giving patients chemotherapy and chemoradiation prior to surgery may yield a better long-term outcome than surgery upfront".
However an estimated 25% of patients stop within two years because they can not endure the side effects, lead author Dr Sherry Shen, of the New York Presbyterian Hospital, said.
The study, led by the Albert Einstein Cancer Center in NY, is a rare cancer breakthrough as it can save money and instantly change practice.
Although the new findings are extremely promising for women who have early-stage breast cancer, the conclusions may not apply to those who have larger tumors or those battling cancer that has spread throughout the body.
Studies have shown that women in the low risk category can effectively be treated without receiving chemotherapy, while those with a high risk of recurrence do need chemo.
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All women like those in the study should get gene testing to guide their care, said Dr. Richard Schilsky, chief medical officer of the oncology society. Without the stamp money, the study may never have been done, he said. Most women in this situation don't need treatment beyond surgery and hormone therapy, he said. Similar tests including one called MammaPrint also are widely used. This data adds to findings from a TAILORx analysis published in 2015 that provided prospective evidence that the gene expression test could identify women with a low risk of recurrence who could be spared chemotherapy.
The study was extensive so patients who fit in this new category should be very confident with their course of treatment, even if it's without chemotherapy. "Towards the end, my eyes would water", she said.
Dr. Newman said there is one caveat.
Adine Usher, 78, who lives in Hartsdale, New York, joined the study 10 years ago at Montefiore and was randomly assigned to the group given chemo. Her hair fell out, she developed an infection and was hospitalized for a low white blood count, "but it was over fairly quickly and I'm really glad I had it". "I sort of viewed chemo as extra insurance", she said.
"If physicians had recommended she bypass chemo Depending on the chemical test,"that I Would have confessed that", she explained. research".
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