Breast cancer: Who can avoid chemotherapy post-surgery?

Personalized treatment for breast cancer patients is prevalent as oncologists strive not to over-treat them with unnecessary chemotherapy.
breast cancer treatment
Not everyone needs chemotherapy after a breast cancer surgery. Image courtesy: Shutterstock
Dr Ashwin Rajagopal Published: 20 May 2022, 12:00 pm IST
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When 36-year old Ritu was diagnosed with breast cancer, she was devastated thinking about the toll that chemotherapy would have on her physical and mental health. Fortunately, her doctor recommended a prognostic test to understand her tumor biology better and to know the risk of recurrence of cancer. The test classified Ritu at low risk for recurrence and so, her doctor decided to skip chemotherapy for her. She was relieved. Even now, five years later, she is doing well without any sign of recurrence of the disease. Many early-stage patients like Ritu can avoid over-treatment just by taking a prognostic test to determine the recurrence of breast cancer.

Shift in breast cancer treatment

We all live in the era of precision oncology, where the goal is to deliver the right cancer treatment to the patient at the right dose and the right time. The treatment for breast cancer has seen a paradigm shift in the past few years. Most breast cancers are now treatable with good outcomes, if detected early.

breast cancer
Breast cancer treatment needs care and caution. Image courtesy: Shutterstock

Being accepted as a heterogeneous disease with various molecular subtypes, breast cancer treatment is no more considered as one treatment fits all. Hence, clinicians agree that chemotherapy is not the only answer to breast cancer for certain sub-types of the disease. Research shows that it differs from person to person based on genetic heterogeneity. This molecular subtyping of breast cancer has helped patients to safely avoid chemotherapy and have the benefit of getting personalized treatment.

Breast cancer cells that express hormone receptors require estrogen or progesterone to grow, so they tend to express these hormones. Hormone Receptor-positive subtype accounts for 70-80 percent of all cases of breast cancer diagnosed. In early-stage hormone-positive, HER2/neu negative type of patients, prognostic tests are an essential part of treatment decision making. The vast amounts of data gathered from thousands of patients have shown that only 15 percent of patients who are hormone positive, HER2/neu negative breast cancer patients will benefit from chemotherapy. A vast majority of patients are, therefore, able to avoid high costs and chemotherapy side-effects such as hair loss, general weakness and lower immunity, and have better quality life.

Also, read: How to do a self breast examination to prevent breast cancer?

breast cancer
Prevention is better than cure. Image courtesy: Shutterstock

Prognostic tests for breast cancer patients

Personalized treatment for patients, who are still in early stages, is increasingly prevalent, as oncologists strive not to over-treat them with unnecessary chemotherapy. In different parts of the world, doctors now use prognostic tests to determine the best course of treatment for their patients. These tests form the basis of determining the risk of recurrence of certain cancers based on the specific genes or biomarkers involved.

Recent cancer treatment advances have had a tremendous impact on both patients and their families. The goal of oncology treatment is to achieve disease-free survival without compromising on the overall well-being. Precision oncology tailors’ therapy to each individual patient based on the unique biology of cancer, while ensuring the highest long-term quality of life for the cancer survivors.

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About the Author

Dr Ashwin Rajagopal, Consultant - Surgical Oncology, Manipal Hospital ...Read More

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