BREAST CANCER: SIZE MAY NOT MATTER

Genetic testing shows aggressiveness of even small breast cancer tumors. It was once thought the smaller the more benign, we know that is not always the case.

The decision to treat breast cancer patients with chemotherapy used to be easy, didn’t it?  Breast cancer patients whose tumors were small didn’t need chemotherapy.  Or maybe just hormonal therapy.

But the biology of an individual woman’s breast cancer may change  all that.  We’re now in the age of “precision medicine.”  To put it another way, your breast cancer specialist may now be able to custom tailor your treatment to your specific breast cancer’s genetic makeup.

ARE SMALL TUMORS LESS DANGEROUS?

In the study of 6,693 women in Europe, a total of 826 breast cancer patients had very small (less than 1 cm) breast cancers and no spread to the lymph nodes.  By use of a special genetic test (called MammaPrint) on the breast cancer itself, the doctors were able to identify 23.7% of women who were “low risk” by the old criteria but “high risk” by the new genetic test.  The key result was that the “high risk” breast cancer patients with small cancers did better on chemotherapy.  In fact, the 5 year survival rate was 98.5% with chemotherapy, but only 95.8% without it in those women who were “low risk” by the old criteria but “high risk” by the MammaPrint genetic test.

The results of this clinical trial (called MINDACT) was recently reported in the September 2017 meeting of the European Society for Medical Oncology held in Madrid, Spain.  Dr. Evandro de Azambuja of The Jules Bordet Cancer Institute in Brussels commented on the study and said “Small, node-negative tumors can be very aggressive, even if they are classified as low clinical risk.  Tumor biology needs to be taken into account when deciding adjuvant treatments in this patient population.”  And Dr. Konstantinos Tryfonidis, the senior author of the MINDACT trial, of the European Organization for Research and Treatment of Cancer in Brussels said “Our results challenge the assumption that all small tumors are less serious and do not need adjuvant chemotherapy.”

If you have any questions about the treatment of your breast cancer -with chemotherapy, hormonal therapy, or radiation therapy- please feel free to call me, Dr. Edward Hughes, at 855-Dayton1.  I guarantee that I will see you in 1-3 days.