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Breast Cancer Breakthrough Could Predict Recurrence Risk for Thousands of UK Women




Wednesday 19 October 2011



Scientists have developed a cost effective test to help identify which of the 37,000 women diagnosed with ER positive breast cancer each year are at risk of the disease returning. 



The scientists, from The Institute of Cancer Research (ICR) and Queen Mary, University of London and funded by Breakthrough Breast Cancer, Cancer Research UK and the NIHR Biomedical Research Centre, believe this approach, which could be rolled out within the next one to two years, will help doctors identify high risk patients early on allowing for more targeted treatment and avoiding unnecessary chemotherapy for those at lower risk of recurrence.



The findings, published today in the Journal of Clinical Oncology, show that measuring the levels of four proteins - ER, PR, HER2 and Ki67 - is just as effective at predicting high and low risk women as the successful but expensive American Oncotype DX®.  The Oncotype test is only available in one laboratory in the United States and costs approximately £2,500 per patient.  In contrast, the new IHC4 test uses two assays that are routinely analysed at the point of diagnosis in the UK (ER and HER2) and two more (PR and Ki67) that are simple and could be easily performed throughout the country using equipment already available in many laboratories.


Professor Mitch Dowsett speaking about the new breast cancer test



Study co-leader Professor Mitch Dowsett, from the Breakthrough Breast Cancer Research Centre at the ICR and The Royal Marsden Hospital, said: “This is fantastic news for women who are diagnosed with ER positive breast cancer. It is a major step towards more personalised and targeted treatment of breast cancer, which will mean that women can avoid unnecessary chemotherapy and its toxic side effects.


“Oncotype DX®is a valuable method of identifying patients whose breast cancer could re-occur but most cancer specialists do no have the money available to use it.  IHC4 could make this information available to them without adding significantly to NHS costs and in fact could help reduce spending by cutting unnecessary chemotherapy treatment.”




Professor Dowsett’s team used a pool of over 1,800 samples collected from the TransATAC clinical trial to compare the IHC4 method with the established Oncotype DX® technology. Once they had concluded that the IHC4 test was just as effective in identifying high and low risk women they rolled out the comparison to another group of patients in Nottingham and reproduced the same findings.



Study co-leader Professor Jack Cuzick, from Queen Mary, University of London, said: “Although tests such as Oncotype DX® have been developed and are informative, they can be expensive and involve sending samples to the US, which limit their use in many parts of the world.  Clinicians may therefore have to make therapy decisions based on limited prognostic information.


The new IHC4 technique bypasses any barriers due to the ease with which the test can be implemented and it has the potential to be a key component in the battle against breast cancer.”





Media contact: Sarah Viner in the Breakthrough Breast Cancer press office on 020 7025 2432 or email [email protected]. Out of hours mobile is 07778 682 001.

Notes to editors:

Breakthrough Breast Cancer

  • Breakthrough Breast Cancer is a pioneering charity dedicated to the prevention, treatment and ultimate eradication of breast cancer fighting on three fronts: research, campaigning and education. 
  • Breakthrough Breast Cancer funds ground-breaking research, campaign for better services and treatments and raise awareness of breast cancer.  Through this work the charity believes passionately that breast cancer can be beaten and the fear of the disease removed for good. Find more information at

Breast Cancer

  • Breast cancer is the most commonly diagnosed cancer in the UK – nearly 48,000 women and around 300 men are diagnosed every year
  • One in eight women in the UK will develop breast cancer at some point in their lifetime
  • The good news is that more women than ever in the UK are surviving breast cancer thanks to better awareness, better treatments and better screening


About the research

The work was funded by the Royal Marsden NIHR Biomedical Research Centre, CRUK programme grant C569-10404 and grants from Breakthrough Breast Cancer and AstraZeneca.


About Mary Jean Mitchell Green Foundation

The Mary-Jean Mitchell Green Foundation was one of the main funders of this research. Set up in loving memory of wife and mother Mary-Jean, the Foundation has supported Breakthrough Breast Cancer's vital work since its inception, with gifts totalling £4.5 million. Breakthrough is very grateful to our Founding Benefactor Peter Green, his sons Alexander and Andrew, and Ron Beedie for their continued support in the fight against breast cancer.

The Institute of Cancer Research (ICR)

  • The ICR is Europe’s leading cancer research centre
  • The ICR has been ranked the UK’s top academic research centre, based on the results of the Higher Education Funding Council’s Research Assessment Exercise
  • The ICR works closely with partner The Royal Marsden NHS Foundation Trust to ensure patients immediately benefit from new research. Together the two organisations form the largest comprehensive cancer centre in Europe
  • The ICR has charitable status and relies on voluntary income, spending 90 pence in every pound of total income directly on research
  • As a college of the University of London, the ICR also provides postgraduate higher education of international distinction
  • Over its 100-year history, the ICR’s achievements include identifying the potential link between smoking and lung cancer which was subsequently confirmed, discovering that DNA damage is the basic cause of cancer and isolating more cancer-related genes than any other organisation in the world

For more information visit


The Royal Marsden opened its doors in 1851 as the world’s first hospital dedicated to cancer diagnosis, treatment, research and education.

Today, together with its academic partner, The Institute of Cancer Research (ICR), it is the largest and most comprehensive cancer centre in Europe treating over 44,000 patients every year.  It is a centre of excellence with an international reputation for groundbreaking research and pioneering the very latest in cancer treatments and technologies. The Royal Marsden also provides community services in the London boroughs of Sutton and Merton and in June 2010, along with the ICR, the Trust launched a new academic partnership with Mount Vernon Cancer Centre in Middlesex. 

Since 2004, the hospital’s charity, The Royal Marsden Cancer Charity, has helped raise over £50 million to build theatres, diagnostic centres, and drug development units. Prince William became President of The Royal Marsden in 2007, following a long royal connection with the hospital.

For more information, visit

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