Breast cancer patients could be spared chemotherapy with new test

[dixiegrrrrl]

Tens of thousands of breast cancer patients could be saved from undergoing gruelling chemotherapy with a new test which shows whether drugs will be effective.

Many women with early stage breast cancer get no benefit from chemotherapy after having surgery and radiotherapy but some still receive treatment to be on the safe side.

Now a new test which screens for 70 genetic variants which increase the risk of cancer returning, has found to be effective at predicting which patients can be spared treatment.

Results showed that around 46 per cent of women with newly diagnosed early-stage breast cancer were classified as low risk by the test, called MammaPrint, and did not need medication.

http://www.telegraph.co.uk/science/2016/08/24/breast-cancer-patients-could-be-spared-chemotherapy-with-new-tes/

NOTE: Here in USA there are several genetic tests which can predict the same thing with about 80% certainty.
Here is a link to the ones used in US:

http://www.breastcancer.org/symptoms/testing/types/oncotype_dx


(I have printed out the info and will be talking to the oncologist tomorrow.)

[PennyK]

1. Very good info

Glad you will have this info to take with you.
I had genetic testing, since I'm an Ashkenazi Jew; results were negative...great news for my sister and also helpful to my daughters.

[Ms. Toad]

2. If your doctor doesn't bring it up independently,

start searching for another doctor.

Even the team of doctors I fired brought up both generic genetic testing, as well as the oncotype dx testing. Any doctor who doesn't discuss it has not been paying attention to the latest research, and since knowledge of breast cancer is changing almost faster than it can be written down, you need a doctor who is attentive to all of the latest research.

[dixiegrrrrl]

3. Good info to know.

I have only meant with the doc once, at that time he ordered some more tests.
Today I meet to discuss test results and I will bring up the genetic testing.

Problem is , the oncology unit is brand new to the hospital here in the rural part of the state, and there is no other place to go within 100 miles.

[Ms. Toad]

8. I didn't go 100 miles, but I did go 50 -

rather than less than 1 mile.

My first team had issues with timely, accurate communication. I gave them a warning, making it clear that dealing with the uncertainty of cancer was all I could manage - that I could not tolerate communications from their office being unpredictable.

(They didn't send the letter telling me I needed a follow-up mammogram after my screening one, blamed me for losing it, promised to resend it - then called back to the wrong number 5 minutes later in a panic because they hadn't bothered to check when I was on the phone and realized that I urgently needed a follow-up {now 2 weeks later than they should have told me of the need}, scheduled the appointment for Tuesday, called Tuesday to confirm my Wednesday appointment, then asked why they had not yet received my doctor's referral {they self-referred from the screening mammogram to the diagnostic mammogram, and hadn't bothered to inform me that they (not my insurance company) needed an additional referral from an out-of-system doctor . . . and on, and on, and on.)

After about double that number of similar untimely or inaccurate communications, I fired them. That meant that for radiation treatment, I had a 78 mile round trip every day for 17 days. (The surgery was a 100 mile round trip, but they had an outpatient facility a tad closer for radiation.) It was worth it.

I would have expected to have to travel in my home state of Nebraska (my mother traveled 100 miles for her first mastectomy). Now that I live in a more urban area, the need was a surprise - but definitely needed from a confidence in my medical care team perspective.

[dixiegrrrrl]

11. Firing them was the least you could do, I agree.

The hospital staff here is so much improved over what it was years ago.
And, being the county seat, I know many of the people working there.
communication is very good, mostly, and epecially when I call needing to talk to someone, I get a callback quickly.

best of all, our hospital will work out payments, with no interest.

[dixiegrrrrl]

7. Just saw doc, he is ordering the test!

The oncology unit here is very patient oriented, it is quite noticeable.

will know results in 2-3 weeks, assuming Medicare approves the request.

[Ms. Toad]

9. Yay!

There are two series of genetic tests - one a blood/saliva test, and the other a test of the tumor itself.

I had both. In theory both were supposed to be covered. I'm still fighting about the first (blood) for which the company expressly obtained advance approval.

The second has a hefty "charity' subsidy that I am eligible for, so it should be free (or nearly free) even if the insurance company ultimately rejects it.

[dixiegrrrrl]

10. ty for that info.....

Looks like they are gonna send some samples of the tumor, which thankfully they kept after surgery.

Which made me wonder ...how long does a lab hold onto your specifmens? Is their a rule/law about time? hmmm.

I will feel tons better if I have to have chemo becuase it seems warranted as opposed to having it because it is the treatment protocol for everyone,
no matter what kind of breast cancer they have.

[Ms. Toad]

12. The lab that processed the tumor will hold it quite a while.

Not sure how long - but at least months.

[shrike]

4. Mammaprint has actually been around, maybe new to the UK

I had the Oncotype test and was told by my onc that it showed not only would I not benefit from chemo, but that it would have a negative effect, meaning it could hurt me.

I encourage any early stage BC patient to inquire about such tests, find out if they were a candidate. I've been amazed at the number of people who know nothing about them. I was at a BC survivors luncheon, and a woman who was there with her survivor friend asked for my contact info! She wanted to call me in case she ever got breast cancer herself. I'm no expert, but I was talking about subjects they'd never heard of. Patients really have to be advocates too, or at least have a loved one willing to be an advocate.

[dixiegrrrrl]

5. that test is gonna be discussed today with my doc.

I have found breastcancer.org to be extremely helpful, and many times I can look things mentioned on that site. Lots of good input there from cancer patients.

[shrike]

6. Yes, that site was a sanity saver for me, too.

Glad you're finding it helpful.

[PennyK]

13. Somewhat late for me, BUT

I see that the test's results can also be applied to radiology, so I, too, am going to talk to my doctor about genomic testing. Thanks again, dixiegrrrrl!

[dixiegrrrrl]

14. Here is the link which discusses the various tests

http://www.breastcancer.org/symptoms/testing/types/oncotype_dx

I apparently glossed over the part about radiation, glad you caught it.

The doc I talked to ( they have different docs on different days) was a bit reluctant at first to think outside of the box, but I was firmly persuasive.

Do let us know what your doc says.

[PennyK]

15. Ok, I finally took a few minutes to read this

I was getting ready to see what to print and present to my doctor, and then I realized that these test are for one species of cancer, ER-positive. Mine is (or was) HER2-positive. According to what I read, there are basically three types, the third being triple negative. So, that's that. The article does mention other tests that can predict a recurrence in the future of my type, which is good.

Still, thanks again for this very good information, dixiegrrrrl.

[dixiegrrrrl]

16. Hopefully you will find an availble test,Penny.

I stumbled on this info. a few days before the Dr. appt which was intended to be plans to start chemo, but instead was able to argue for the test.