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    Test Could Spare Women From Chemotherapy

    Up to 40,000 Women a Year Can Safely Skip the Toxic Drugs


    In those women with a low recurrence score, the risk of cancer spreading to other parts of the body -- what doctors call distant recurrence -- was only about 5%, regardless of whether chemotherapy was given.

    But in women at high risk, there was a clear benefit: About 88% of those who got the one-two punch with chemotherapy and tamoxifen were free of cancer 10 years later, compared with only 60% of those who got tamoxifen alone.

    And women at intermediate risk? The benefits are still unclear, the experts say, adding this group will be studied more in a new National Cancer Institute trial.

    In the meantime, Wolmark urges eligible women to have the test. "Women should find out their risk of recurrence," he says. "Based on that risk, they can make a more informed decision about whether or not to move ahead with chemotherapy

    His second study, presented here today at the annual San Antonio Breast Cancer Symposium, shows that the 50% of women who fall into the low-risk category gain little if any benefit from chemotherapy.

    Breast Cancer Overtreated

    Current guidelines call for about 90% of women whose breast cancers are estrogen-dependent and who do not have cancer in the lymph nodes to get chemotherapy to reduce the odds of the cancer returning, says Sheila Taube, PhD, associate director of the Cancer Diagnostics Program at the National Cancer Institute. The one-size-fits-all approach leads to a huge amount of overtreatment, she says. That's where the new test comes in, says Eric Winer, MD. "His data will push us more in the direction of not giving it to these women. It's very significant information that can help us to avoid unnecessary treatment."

    William Gradishar, MD, a breast cancer specialist at Northwestern University in Chicago, and a spokesman for the American Society of Clinical Oncology, agrees. He says he hopes that the new research will propel insurance companies, which have been reluctant to cover the $3,460 test, to start picking up the tab.

    Christina Koenig, who faced the agonizing decision of whether to undergo chemotherapy when she was diagnosed with breast cancer several years ago, says the test could help spare women from infertility, a common side effect of chemotherapy.

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