After five years, 92.8 percent of the women who received hormone therapy alone, and 93.1 percent of those who received hormone therapy plus chemotherapy, were cancer-free. However, most breast cancer occurs in older women.
Sparano noted that given the several variations of endocrine therapy now available, women who have trouble tolerating one should try another.
A patient's tumour is genetically analysed to identify the rare changes that might make the cancer visible to the immune system. "We are de-escalating toxic therapy".
'I'm delighted. I've been anxious for a long time about unnecessary treatment for cancer, and unnecessary side effects from chemotherapy, ' Dr. Otis Brawley, the chief medical and scientific officer for the American Cancer Society who was not part of the study, said.
Along with hair loss, nausea and vomiting, chemo can leave a woman with a depressed immune system, said Dr. Jennifer Litton, an oncologist and an associate professor at the University of Texas MD Anderson Cancer Center.
A group of metastatic breast cancer experts has urged policymakers to empower patients with greater choice and participation in their treatment and care, to improve the quality of life of patients, their carers and families. Very low scores, up to 10, it's a very low chance that these patients get hormone therapy, and chemotherapy doesn't help them.
Not all breast tumors behave the same way, with a number of different subtypes of breast cancer defined by genetic and protein markers.
"Now, the vast majority of patients can potentially receive benefits from immunotherapy instead", he added. Almost 7,000 patients' scores fell into the middle range, between 11 and 25.
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In this latest study, researchers focused on the 69 percent of the clinical trial's participants who had mid-range test scores.
Past experiments revealed that one group of people particular results of the genetic test would benefit from a combination of endocrine therapy and chemotherapy. "The gray area has been the mid-range RS score of 11 to 25-this target population accounts for about 50% of women in the United States", Soprano said.
Women aged 50 or younger were the notable exception.
Among women younger than 50, outcomes were similar when gene test scores were 15 or lower. These women should discuss chemotherapy with their doctors, the researchers said.
The text messages were most effective at reducing distress at the 2- and 4-month marks, according to the data presented by chief author Kuang-Yi Wen, an assistant professor in the Cancer Prevention and Control program at Fox Chase. For the group that had both hormone and chemotherapy, the rate was 84.3%, a difference that was not statistically significant. That means more than 85,000 women a year can safely forgo chemotherapy.
Some cancer specialists have been postponing the decision to treat their newer patients with chemotherapy until the study findings were released.
"Chemotherapy is an absolute cornerstone of breast cancer treatment, but with the side-effects being nearly unbearable for some we must ensure it is only given to those that will benefit from it".
Gilead's Kite unit signed a development agreement for the experimental therapy, Rosenberg said. Genes are either off or on.
"This is going to provide the highest level of evidence now for our test being indispensable in clinical practice", Shak said.
"You can get them to the same place... without side effects and toxicity", he said. Should we not give them chemotherapy?