A new study—the largest of its kind—says that women who are diagnosed with the most common type of early-stage breast cancer most likely don’t need chemotherapy after they’ve had endocrine (hormone) therapy. The news could lay to rest some anguished conversations between doctors and patients. When a woman is diagnosed with breast cancer, all medical muscle goes toward eliminating the cancer and reducing the possibility of a recurrence. But for many women, chemotherapy can have disastrous results. This study says that if the additional treatment isn’t necessary—or has little measurable positive effect—many women can skip it.
A genetic test that helps doctors determine how best to treat breast cancer—and whether chemotherapy is likely to help—is significantly more likely to be administered to white women than blacks or Hispanics, a Yale study has found. The test, called Oncotype Dx (ODx), uses gene expression to gauge how early-stage breast cancer is affecting patients’ gene activity. It uses the information to determine how likely cancer recurrence would be, and physicians and their patients can use that knowledge to decide how to proceed with treatment. Yale researchers retrospectively analyzed a group of more than 8,000 Connecticut women who were diagnosed with hormone receptor positive breast cancer between 2011 and 2013, and found “significant racial and ethnic disparities in use of this new gene test,” said study leader Dr. Cary Gross, a member of Yale Cancer Center and professor of medicine and epidemiology at Yale School of Medicine. “It reinforces that, at the same time we are investing in developing new treatments and new testing strategies and we’re promoting them with great excitement, we really need to double-down our efforts to eliminate disparity,” Gross said.
Black women with breast cancer fare worse than other women when treated with early chemotherapy, according to new research from the Yale Cancer Center. Typically, black, Hispanic and Asian women are more likely to undergo neoadjuvant chemotherapy, or chemotherapy prior to surgery, than white women because they are more likely to develop advanced-stage breast cancer. But the new study found that black women are less likely to benefit from the treatment. The finding is significant because it proves further research is needed, and could impact how future research and treatment options are pursued for black women, said Brigid Killelea, the study’s first author and associate professor of surgery at Yale School of Medicine. “African American women didn’t respond as well to the chemotherapy when a pathologist looked at the tumors under a microscope after [subsequent] surgery,” she said.
The U.S. Supreme Court’s decision today to invalidate a Utah company’s long-held patents on genetic testing for breast and ovarian cancer is expected to result in the test being more accessible to women, at a lower cost, experts say. The court’s 9-0 decision comes four years after the American Civil Liberties Union on behalf of 20 named plaintiffs, including Ellen Matloff, director, Cancer Genetic Counseling at the Yale Cancer Center, filed a lawsuit charging that the patents held by Myriad Genetics of Utah on the DNA of two genes, known as BRCA1 and BRCA2, is unconstitutional and should be ruled invalid. The lawsuit also challenged Myriad’s right to set prices on their exclusive testing that critics said “locked out” some women from affording the life-saving test, which costs about $3,450. “I am thrilled with the decision. I think it’s been inhumane for one company to make the call on how much these important tests will cost,’’ said Marya DiPerna, of Naugatuck, whose own BRACAnalysis genetic test was negative a year ago. The patent “made it unavailable to those whose insurance won’t pay for it and who cannot personally otherwise afford it,’’ added DiPerna, who applauded the decision. “I was lucky that my husband’s insurance covered the cost because my sister, a deployed Marine’s wife, had breast cancer. She had to fight for her test while she was sick and at first, she was denied,’’ added DiPerna. Her sister could not afford to pay for the test while she was in treatment and raising her children alone as a military mom.