Test cuts need for chemotherapy for some breast cancer patients

by Tom O'Connor, UNMC public relations | May 16, 2013

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James Edney, M.D.
A new gene test for patients with breast cancer -- called MammaPrint -- could dramatically reduce the number of women who need to undergo chemotherapy to treat the disease.

The test is available at UNMC and its hospital partner, The Nebraska Medical Center. It analyzes 70 key genes and accurately determines which patients are at low risk of breast cancer recurrence and could safely choose not to undergo chemotherapy.

The test has been validated in a peer-reviewed study called Microarray Prognostics in Breast Cancer (or RASTER), conducted in 16 community-based clinics in the Netherlands. The results were published online earlier this year in The International Journal of Cancer and will later appear in the journal's print edition.

The five-year study involved 427 breast cancer patients who were given the MammaPrint test. The test determined 219 women to be low risk and 208 to be high risk.

"By incorporating MammaPrint results along with the traditional clinical parameters, such as tumor size, grade, patient age and lymph node status, we can significantly reduce the number of women who need chemotherapy."

James Edney, M.D.

Of the 219 low-risk patients, 85 percent chose not to have chemotherapy. Of those patients, 97 percent were disease-free after five years.

Of the 208 high-risk patients, 81 percent chose chemotherapy and 91 percent were disease-free after five years.

"This is an important breakthrough for breast cancer patients," said James Edney, M.D., UNMC professor of surgical oncology. "By incorporating MammaPrint results along with the traditional clinical parameters, such as tumor size, grade, patient age and lymph node status, we can significantly reduce the number of women who need chemotherapy. In doing so, they can avoid the side effects and toxicity of chemotherapy treatment, some of which can be permanent and debilitating."

Long-term side effects of chemotherapy could include damage to the heart, kidneys, lungs, nerves or reproductive organs. There is also the chance of developing a second cancer as a result of chemotherapy, Dr. Edney said.

Dr. Edney has used the test on approximately 160 patients, and it has been met with an extremely positive response, he said.

Unlike other breast cancer genomic tests that are limited to patients with certain disease characteristics, such as certain receptor and lymph node status, Dr. Edney said MammaPrint can be administered to virtually all early-stage breast cancer patients. It requires a breast cancer assay performed on either fresh or fixed tumor tissue.

MammaPrint results benefit the physician, he said, by clearly categorizing all patients as high or low risk and eliminating the uncertainty of indeterminate scores reported by other genomic test methods.

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