Many Women with Early-Stage Breast Cancer Can Skip Chemotherapy

Depending on age, many women with estrogen-positive HER2-negative breast cancer don’t need chemo.

It turns out that many women with early stage breast cancer don’t need chemotherapy. The recent study called the TAILORx trial found that thousands of women with a certain type of early-stage hormone-positive, HER-2 negative breast cancer did just as well with hormone therapy alone. These results will be practice-changing, said Kristen D. Whitaker, MD, a clinical cancer geneticist specializing in breast cancer at Fox Chase Cancer Center.

About 1 in 8 women in the US get invasive breast cancer. Half of these cancers are due to estrogen-sensitive tumors that test negative for the HER2 protein, a protein that promotes the growth of cancer cells.

Breast cancers that test positive for HER2 tend to be more aggressive than other types of breast cancer and are less responsive to hormone therapy alone, which is why patients with this disease are usually treated with a combination of chemotherapy and hormone therapy.

But, patients with cancers that test negative for HER2, have a lower risk of cancer recurrence, and have estrogen-positive cancer in an early stage that hasn’t spread to the lymph nodes, may be able to skip chemotherapy and just take hormone therapy alone.

“The TAILORx trial found that chemotherapy can be avoided in about 70 percent of women with estrogen sensitive, HER2-negative, lymph node-negative breast cancer,” Whitaker said. “This is exciting because we now have data to better tailor treatments.”

One exception is that some women younger than 50 do benefit when chemotherapy is added to hormone therapy.

“Prior to this trial we didn’t have evidence-based data on how to optimize therapy for women with an intermediate risk of cancer recurrence based on the Oncotype DX , a genomic test that helps predict the chance of cancer returning and the benefit of chemotherapy,” Whitaker said. “Now we have the highest level of evidence on treatment for women with intermediate recurrence risks. The results will continue to be incorporated into clinical practice as providers’ awareness of the results of TAILORx increases,” she said.

What You Need to Know About Skipping Chemotherapy

  1. Many women with hormone-positive, HER2-negative, lymph node-negative early-stage breast cancer who have intermediate risk of cancer recurrence do not need chemotherapy.
  2. The exception is that some women who are younger than 50 may benefit when chemotherapy is added to hormone therapy.

Find out more about breast cancer treatment options at Fox Chase.

Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

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