Following the news of a test that may mean fewer women are offered chemotherapy for breast cancer, we look at what this means, why chemotherapy is given, and what to do if you’re not sure whether you should have it.
‘Thousands’ could avoid chemo
You may have read the news that a 'test means fewer women will need chemotherapy'.
The news reports follow a study, called TAILORx, of a test widely used on the NHS.
The test – Oncotype DX – predicts whether someone would benefit from chemotherapy.
The test is suitable for women whose breast cancer:
By examining breast tissue removed during surgery, the test assigns a score from 0 to 100. The higher the score, the more likely the benefit from chemotherapy will be. Below a certain score, chemotherapy is known to have no benefit.
However, there's a significant ‘grey area’ of women for whom the benefit is unclear. The researchers looked at this intermediate group. They concluded that for most women in this group over the age of 50, chemotherapy didn't have any benefit, and hormone therapy alone led to similar survival rates. For some women under 50 in this group, chemotherapy could also be spared.
This means that several thousand women a year could avoid having chemotherapy, which can cause a range of often unpleasant side effects.
You can read a more detailed analysis of the study on the NHS Choices website.
Why are people offered chemotherapy?
Chemotherapy is given to reduce the risk of breast cancer coming back in the future. It uses anti-cancer drugs to destroy cancer cells.
It is most commonly given after surgery.
Some people wonder why they need chemotherapy if they’ve already had surgery to remove their cancer. Whether someone is offered chemotherapy depends on a number of features of their cancer. These include the size and grade of the cancer; whether it has spread to any of the lymph nodes under the arm; and whether the cancer is hormone receptor and HER2 positive or negative.
For some people the benefit is clear, but for others it’s less certain. This is why cancer specialists may use a test, like the one described above, to help estimate the benefit.
Because it affects cells throughout the body, chemotherapy can cause side effects including sickness, hair loss and an increased risk of infection.
Women who have the test should discuss the results with their specialist to help them decide whether having chemotherapy, in addition to hormone therapy, will benefit them.
If you’ve been asked to decide whether to have chemotherapy, you can talk it through with your cancer specialist or breast care nurse, who can answer your questions and support you with your decision.