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Gen test can predict risk of breast cancer death


New test saves many women from overly aggressive treatment
Researchers have now developed a molecular test for women with breast cancer that can predict the risk of premature death, even 20 years after diagnosis and subsequent tumor removal. As a result, affected patients could be treated less aggressively.

The University of California scientists found that a molecular test can predict which breast cancer patients are at very low risk of dying from their condition. This prediction is reliable for a period of up to twenty years. The doctors published the results of their study in the journal "JAMA Oncology".

Test can avoid overtreatment and save women from toxic effects
The current test can predict the likelihood of death from breast cancer up to twenty years after a breast cancer diagnosis and subsequent tumor removal, the researchers say. This means that patients with a low risk can be treated less aggressively and over-treatment is avoided. The experts explain that this also results in less negative toxic effects. The results of the study are an important step for the individual care of women with breast cancer, explains the author Dr. Laura Esserman from the University of California.

The test is designed to identify low-risk patients
The new test can save women with a low risk of death from breast cancer from the aggressive treatments (such as radiation), the scientists explain. It was possible to run the test at the time of diagnosis, thereby identifying patients with very low risk tumors. About 20 to 25 percent of the tumors diagnosed today fall into this category, says Dr. Esserman.

Can a gene test predict the likelihood of breast cancer death?
In their current investigation, the researchers tried to determine whether a so-called 70-gene test can accurately and reliably identify tumors with indolent or slow-growing behavior. The test should then be used to assess the risk of cancer death up to twenty years after diagnosis, the experts say. The same test had already shown last year that it enabled nearly half of breast cancer patients in the early stages to skip chemotherapy based on the biological makeup of their tumors, the authors add.

The test is designed to predict the long-term risk of death from breast cancer
The so-called MammaPrint test examines the signature of 70 genes to predict whether breast cancer patients will develop cancer again, the researchers say. In the current analysis, physicians attempted to determine whether they could predict the risk of breast cancer death over a 20-year period when those affected had almost no risk of metastatic progress.

Doctors examined almost 1,800 women
A total of 1,780 lymph node-negative patients with tumors approximately three centimeters in diameter were examined. The patients were divided into two different groups. One group received so-called adjuvant therapy, which was supposed to suppress the recurring formation of tumors. The other group served as a control group. All of the participating women had their tumors surgically removed.

Scientists create medical profiles of 652 women
The researchers then used the removed tissue to profile a total of 652 women, of whom 311 had received tamoxifen and 339 participants had no therapy at all. The majority of these women (79 percent) had mastectomy and lymph node removal, the doctors add.

Gen-Test worked reliably and found 98 women with a very low risk
The current test classified 42 percent of the participants as high-risk patients. 58 percent of women were assigned a low risk, the researchers say. Low-risk patients had a 95 percent survival rate after five years. However, many later died of their illness, the experts say. The test classified 15 percent (98 women) of the cases as patients with a very low risk. Such women had an excellent prognosis, whether or not they had been using tamoxifen for two years, the scientists explain. The results indicate that the gene test could help doctors and patients determine the further course of treatment in the future. (as)

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