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Breast cancer test could spare some women from unnecessary chemotherapy

A prognostic tool for breast cancer could spare some women from unnecessary chemotherapy, a new study shows.

Researchers at The Institute of Cancer Research and The Royal Marsden showed that when a prognostic tool called the IHC4+C score was used by clinicians to aid their decision making, fewer breast cancer patients were recommended chemotherapy.

Of 124 postmenopausal women with breast cancer who were assessed for their long-term risk of relapse, a quarter could be spared chemotherapy that they didn’t need, the study found.

The findings show the test could support doctors and patients with the difficult decision of whether to undergo additional treatment, and could spare more women from expensive and unnecessary chemotherapy along with its potential side-effects.

The study, published in the British Journal of Cancer, was funded by The Cridlan Trust, with additional support from Breast Cancer Now and the NIHR Biomedical Research Centre at the ICR and The Royal Marsden.

Oestrogen receptor positive (ER+) breast cancer is the most common form of breast cancer diagnosed in the UK, but modern treatment regimens mean that many women with the disease will live for many years after their initial diagnosis.

For some women, routine treatment with surgery and hormone therapy can be so successful that there is very little chance of their disease returning, but for others the risk of their cancer coming back years later means additional chemotherapy can help.

The IHC4+C test was developed by researchers at the ICR and The Royal Marsden, for postmenopausal women with ER+ breast cancer who are treated with hormone therapy, and uses biological and clinically-assessed markers to calculate the risk of a woman’s breast cancer returning up to 10 years after their diagnosis.

Researchers assessed 124 postmenopausal women with ER+ breast cancer where clinicians felt that additional prognostic information could improve decisions about the need for chemotherapy on top of endocrine therapy.

They found that for nearly three quarters of patients studied, the decision made by doctors was not changed by the result of the IHC4+C test. But in the remaining quarter, the IHC4 score result helped clinicians to change their recommendation away from chemotherapy.

Study leader Professor Mitch Dowsett, Head of the Academic Department of Biochemistry at the ICR and The Royal Marsden, said: “Our study tested a new prognostic tool developed by the ICR and The Royal Marsden, in collaboration with colleagues at Queen Mary University of London, called IHC4+C, to see if it could help doctors decide which women would benefit from follow-up chemotherapy. We found the test agreed with doctors’ decisions most of the time, but that it helped a quarter of women decide against having chemotherapy when they were unlikely to need it. The findings show the IHC4+C test could help doctors advise women about their breast cancer treatment, and could spare some women from unnecessary and expensive chemotherapy.”

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