Millions of breast cancer patients could safely avoid chemotherapy, study suggests
Millions of Breast Cancer Patients Could Safely Avoid Chemotherapy, Study Suggests
Millions of breast cancer patients could - Researchers have uncovered a potential breakthrough that could change the way breast cancer is treated, offering hope that many patients may no longer need to undergo chemotherapy. A new DNA test, developed by scientists, has shown the ability to identify individuals who are likely to benefit from the therapy and those who could safely skip it, according to a large-scale trial. The findings suggest that over two-thirds of participants might avoid the harsh side effects of chemotherapy, instead relying on hormone therapy alone.
Understanding the Test and Its Implications
The study, led by University College London (UCL), examined more than 4,000 newly diagnosed breast cancer patients over 40 years old across the UK, Norway, Sweden, Australia, New Zealand, and Thailand. Scientists used a gene test known as Prosigna, which evaluates the activity of 50 genes linked to breast cancer progression. This analysis helps predict the likelihood of the disease recurring, allowing clinicians to make more targeted treatment decisions.
Chemotherapy is commonly prescribed after surgery to reduce the risk of cancer returning, especially for patients with early-stage breast cancer that has spread to nearby lymph nodes. However, the side effects—such as fatigue, nausea, hair loss, immune system weakening, and fertility concerns—can be significant. The UCL-led research indicates that for a majority of patients, these side effects may not be necessary, as their cancer is less likely to come back.
The trial’s results revealed that those who received a low score from the Prosigna test were not treated with chemotherapy. Despite this, their five-year survival rate was 93.7%, which is very close to the 94.9% survival rate of patients who underwent the full treatment. This suggests that for a large portion of the population, the therapy may be overused, leading to unnecessary strain on patients.
Expert Perspectives and Patient Experiences
Professor David Miles, a prominent cancer specialist, highlighted the significance of the findings, calling them “practice-changing.” He explained that the test enables doctors to confidently determine which patients will derive no benefit from chemotherapy. “Previously, we would treat 100 women to help just 10, leaving 90 to endure the treatment without clear advantage,” he said during a BBC interview.
"Cancer diagnosis and treatment can be shocking. It certainly propels you into a world of uncertainty. Life priorities realign—you simply want to survive," shared Karen Bonham, a 64-year-old participant from Cardiff. She avoided chemotherapy through the Prosigna test and received a combination of radiotherapy and hormone therapy over eight years. For her, the results brought “an immense relief” and felt like “Christmas.”
Tanya Hutson, who received chemotherapy in 2022, praised the new test as “absolutely amazing.” She noted that the treatment had been “brutal” for her, but the study’s results could revolutionize care for others. “It just proves what happens when money is put into research,” she added, expressing hope that the test will help those who don’t need chemo avoid its challenges.
Next Steps and Broader Impact
The study’s conclusions will be shared at the American Society of Clinical Oncology’s annual conference in Chicago, where global cancer experts will gather to discuss advancements. This event will provide a platform for clinicians to consider the test’s application in routine practice. However, the research team at UCL emphasized that the findings are currently limited to patients over 40, with further studies needed to determine if younger individuals could also benefit from this approach.
For now, the test represents a major step forward in personalized medicine, allowing for more tailored treatment plans. UCL estimates that over 5,000 NHS patients annually could avoid chemotherapy thanks to this innovation. The potential to reduce treatment intensity while maintaining effectiveness is a promising development in the fight against breast cancer. As the medical community reviews these results, the focus remains on refining the test and ensuring its broader adoption in clinical settings.
Traditionally, chemotherapy has been a cornerstone of breast cancer care, but the study challenges that assumption. By identifying patients at lower risk of recurrence, the test offers a way to balance therapeutic benefits with patient well-being. This could lead to fewer hospital visits, reduced side effects, and more efficient use of healthcare resources. The research also opens the door for future studies exploring how this method might apply to younger patients, expanding its reach and impact.
While the test is still in the evaluation phase, its implications are already being felt by those who have participated in the trial. Karen Bonham’s experience underscores the emotional weight of cancer treatment decisions, as she described the relief of avoiding a regimen that can be physically and mentally exhausting. Her story, alongside others, illustrates how this advancement could transform patient outcomes and quality of life.
Professor Miles stressed that the test provides a reliable tool for clinicians, reducing the burden on patients who might not need chemotherapy. “We can now confidently define a large population of women who don’t need to go through all that unpleasantness for no benefit at all,” he said. This shift toward precision medicine marks a turning point in cancer care, empowering doctors to make more informed choices and helping patients avoid unnecessary interventions.