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Breast Cancer Treatment: Is Chemotherapy Always The Answer?

Nov 05, 2018

When people think of cancer treatment, the first thing that often comes to mind is chemotherapy. However, that’s not always the best option for breast cancer diagnoses. The TAILORx study has revealed that almost 70 percent of women with the most prevalent type of breast cancer don’t need chemotherapy at all. Read on to learn about the impact that the TAILORx will have on breast cancer treatment.

Before the TAILORx Study

When women initially received a positive diagnosis for hormone receptor H(HR)-positive, HER2-negative, axillary lymph node-negative breast cancer, they would undergo another test, called an Oncotype DX Breast Cancer Assay. This test would rank them from 0-100 on how likely their breast cancer was to recur, with 0 being the lowest and 100 being the highest. Women with a score from 0-10 would undergo surgery and then use hormone therapy only. For women in the intermediate range (11-25) and above, the typical treatment would be surgery, followed by chemotherapy and hormone therapy. Doctors have known that a high score (25-100) definitely warrants a combination of chemotherapy and hormone therapy, but they never had conclusive evidence that the combination of treatments was necessary for women with scores in the intermediate range.

What We Learned From the TAILORx Study

In the study, doctors separated women in the intermediate range into two groups, one of which would receive a combination of chemotherapy and hormone therapy and another which would only receive hormone therapy. The difference in survival rates between the two groups was not statistically significant. The doctors came to the conclusion that the chemotherapy didn’t add any additional benefit to those with scores in the intermediate range.

Who Does This Affect?

This news impacts women with a hormone receptor H(HR)-positive, HER2-negative, axillary lymph node-negative breast cancer diagnosis, a recurrence score of 11-25, and are 50 years or older and postmenopausal. “This study is a huge step for breast cancer patients,” says Erin Fleener, MD, medical oncologist at the CHI St. Joseph Health Cancer Center in Bryan, Texas. “Many women can now avoid unnecessary treatments that can cause severe side effects and create a financial burden.”

Doctors still believe women under the age of 50 with a higher intermediate score (16-25) should still receive both chemotherapy and hormone therapy because there were signs that these women did benefit from the added chemotherapy.

If you or a loved one has been diagnosed with breast cancer, schedule an appointment with a CHI St. Joseph Health oncologist to discuss how the TAILORx study might impact your future treatment plan. As the Brazos Valley’s leader in breast cancer care, our experienced team has the tools to provide compassionate, comprehensive care.

New England Journal of Medicine | Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer
National Cancer Institute | TAILORx trial finds most women with early breast cancer do not benefit from chemotherapy
New York Times | Good News for Women With Breast Cancer: Many Don’t Need Chemo