"It works and it works great. It has really changed the way we manage a
substantial proportion of our breast cancer patients," says
Susan K. Boolbol, MD, chief of breast surgery at Beth Israel Medical Center in
New York City.
Boolbol tells WebMD that after the diagnosis itself, "getting
chemotherapy and losing their hair is the biggest concern" of women with
The findings were presented at the American Society of Breast Surgeons
(ASBS) Ninth Annual Meeting.
Moving Away From One-Size Fits All
The test is used to help guide the treatment of estrogen-fueled breast
cancers that have not spread to the lymph nodes. Nearly half of the 182,000
invasive breast tumors that will be diagnosed in the U.S. this year fall into
In the past, about 90% of women with so-called estrogen-dependent,
lymph-node negative breast cancer were given chemotherapy to reduce the odds of
the cancer returning, says Nashville Breast Center's Pat Whitworth, MD,
chairman of the board at the ASBS.
"We couldn't identify who would benefit from treatment, so we had to
treat everyone," he tells WebMD.
Enter OncoType DX, which measures the activity of 21 genes that can raise
breast cancer risk. Based on their activity, women are assigned a recurrence
score: low, medium, or high risk of recurrence.
Studies have shown that women who fall into the low-risk category gain
little, if any, benefit from chemotherapy. Based on those studies, recently
updated guidelines recommend that the test be incorporated into the care of
some women with breast cancer.
"It's really helping to individualize therapy," Whitworth says.
Studies Show Test Spares Women From Chemo
One study presented at the meeting involved 18 premenopausal and 60
postmenopausal women with estrogen-dependent, node-negative breast cancer.
"Prior to Oncotype DX, 39 of the 78 women, or 50%, would have been given
chemotherapy," says Leila C. Thanasoulis, MD, a fellow in surgical oncology
at Bryn Mawr Hospital in Pennsylvania.
With Oncotype DX, chemotherapy was recommended for only nine of the 78, or
12% of the women.
The cost savings: nearly $7,000 per woman, Thanasoulis tells WebMD.
The second study involved 66 women with estrogen-fueled tumors that hadn't
spread to the lymph nodes.
"The recurrence score influenced our treatment decision in 44% of
them," says Juhi Asad, MD, a fellow in the department of surgery at St.
Luke's-Roosevelt Hospital in New York City.