Will I Need Chemo?

Updated: Mar 19, 2021

It’s Sunday Morning. The coffee is brewing and I cuddle up on the couch to start reading the morning news. Half asleep, a little groggy, and scrolling through the media sites on my iPad my scroll comes to an abrupt halt. A flurry of excitement washes over me as I reread the headlines of a breakthrough study literally just published this morning.

Headlines from Genomic Health read:

“Landmark TAILORx Results, Published Today in The New England Journal of Medicine, Demonstrate the Oncotype DX Breast Recurrence Score® Test Definitively Identifies the 70% of Women with Early-stage Breast Cancer Who Receive No Benefit from Chemotherapy, and the 30% of Women for Whom Chemotherapy Benefit Can be Life-saving”

This news was not only published today in the New England Journal of Medicine, but was also announced and presented at the plenary session at the 2018 American Society of Clinical Oncology (ASCO).

Ok, so let’s break this down a bit and I’ll explain why this is so exciting!

First, this was a much-anticipated study and has been in the works for a decade! It illustrates the important relationships and conversations between the patient and the oncologist in determining treatment post-surgery as it relates to one’s prognosis and survivorship.

Medicine is not a perfect science. As much as I wanted to hear that the cancer will never return, and this was a “one and done” experience for me, it’s impossible to get a 100% guarantee. You can comb over reports, data, statistics, get second or third opinions, cry, pray, hope, you name it, but at the end of the day, it’s your decision and one you have to become comfortable with. To quote the whimsical Jerry Garcia, “Nothing is for certain, it could always go wrong”. So let the music keep playing and we make the best decisions with the information we have at the time.

But what this study found, according to Allison Kurian, an oncologist at Stanford University and quoted in the Washington Post revealed today was that these findings “are going to change treatment — and remove uncertainty for women making decisions.”

In 2018 alone, there are going to be approximately 266,000 new cases of breast cancer! Women with early stage breast cancer however, may no longer need chemotherapy. This applies to 85,000 women with the most common type of early stage breast cancer who now, under consultation with their oncologist, may confidently forgo chemotherapy.

Groundbreaking right? So, what is this common early stage breast cancer and how is this all determined?

According to this study, early stage breast cancer referrers to:

You’ve been diagnosed with Stage I or II breast cancer
The cancer is Estrogen-Receptor-Positive
The cancer has not spread to the lymph nodes

If you fall into this category, your medical care team may recommend you receive a genomic test. This test analyses your genes to determine the behavior of the cancer and its likelihood of responding to treatment. This is done by an OncoType Dx Test. Depending on the score of your OncoType, you may be able to forego chemotherapy.

Like any study, there are exceptions and outliers. As published in the Washington Post (2018), Joseph Sparano, associate director for clinical research at the Albert Einstein Cancer Center and Montefiore Medical Center posit that women who are 50 or younger and have received an OncoType Dx recurrence scores of 16 and above got a “substantial” benefit from chemotherapy and should consider it.

There is a lot of uncertainty involved with a breast cancer diagnosis. In some cases, you are living week to week and waiting on test results to know what happens next. There are a lot of challenging time-sensitive decisions to make and long-term stressors that bubble up like “why did this happened to me?”, or “what if it returns?”.

Waking up on a Sunday morning to this news makes my day!

I’ll take this positivity any time! Thank you to all of the researchers, advocates, grant writers, participants, medical care teams, caregivers, and families for moving the needle forward and advancing treatment in breast cancer! Research continues to save lives and I am thrilled that Survivingbreastcancer.org is able to raise awareness through our blog and community outreach and be part of the movement!

Additional resources on today’s topic: