This new test could help more than 5,000 women a year.
Breast cancer is the most common cancer in women in Scotland, with many undergoing gruelling chemotherapy treatments to try and reduce the risk of the disease returning after surgery. However, a major trial has found that a breakthrough test could allow over 5,000 women in the UK to avoid unnecessary treatments each year.
At the moment, patients whose early-stage breast cancer has spread to their nearby lymph nodes are regularly offered chemotherapy. However, this can come with a range of side effects, including a weakened immune system, problems with memory and concentration, blood clots, vomiting, tiredness, or shortness of breath.
Additionally, some types of chemotherapy can also affect fertility, whether that be temporarily or permanently. For patients worried about these potential symptoms, or the chemotherapy having little to no benefit, this new gene test could be a game changer.
The test, called Prosigna, analyses a tumour sample to measure the activity of genes involved in growth. From an international trial led by the UCL, it found that only two per cent of patients with a low score would benefit from undergoing chemotherapy.
Using the test to help identify “who truly benefits from chemotherapy and who does not”, chief investigator and expert in breast oncology at the UCL Cancer Institute, Professor Rob Stein, presented the findings at the world’s largest cancer conference, reports the Express.
He said: “Our findings show that many patients can safely avoid chemotherapy without compromising their outcomes. Many may be spared the physical and emotional burden of chemotherapy and its potential long-term side effects.”
In order to help destroy or reduce cancer cells, chemotherapy uses powerful drugs that can have an impact on the rest of the body. These drugs can also affect healthy body tissue where cancer cells have been constantly growing and dividing.
To find out who truly needs to undergo this gruelling treatment, the OPTIMA trial involved more than 4,400 people from places such as the UK, Sweden, Norway, Australia, New Zealand and Thailand.
The patients each had hormone-sensitive breast cancer and were aged 40 and above. In most cases, the form of breast cancer for these women has spread to their underarm lymph nodes which puts them at a higher risk of recurrence.
The Prosigna genomic test was performed using samples taken from tumours removed during surgery or from needle biopsies. It was found that two-thirds of participants (68%) had a low score.
In the study, participants were randomly assigned to receive treatment guided by their test score or given standard care, which includes a course of chemotherapy and hormone tablets to be taken for five to ten years.
The results of the trial were discovered five years later, with 94.8 per cent of those who received standard care being alive and breast cancer free, compared to 93.6 per cent of those treated with hormone therapy alone.
Due to the small difference between the two groups, researchers believe that the test could be used to determine if patients can avoid having chemotherapy altogether.
Going forward, these results will be considered by the National Institute for Health and Care Excellence, which will determine whether the test should be rolled out through the NHS.
Co-chief investigator Professor Iain MacPherson, of the University of Glasgow, said the research “provides robust, practice‑changing evidence that we can safely reduce the use of chemotherapy for many patients with hormone‑sensitive breast cancer”.
He added: “These findings represent a major step forward in delivering more personalised, precise care, ensuring that treatment decisions are driven by what will genuinely improve outcomes for patients, while avoiding unnecessary toxicity. The potential impact for both patients and health services is substantial.”





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