After the treatment, all patients hope to become completely free of the tumor for the rest of their life. Breast cancer recurrence is a stage that no woman wants to go through. But sometimes the disease reoccurs. To prevent this, early detection of the tumor and application of effective treatments are always considered. In fact, the two main goals of the therapies are to get rid of the tumor and prevent it from relapsing. These therapeutic procedures are not always successful even advanced surgical procedure is applied. Breast cancer recurrence after mastectomy can be locally or distant metastatic.
Oncotype DX, MammaPrint, Mammostrat, and Prosigna
Scientists have been working to predetermine patients who would likely to see their cancer recur. Many genetic tests, Oncotype DX, MammaPrint, Mammostrat, and Prosigna can help identify women with breast cancer at the highest risk of recurrence. In case of negative results, these women could be spared the need of taking chemotherapy, from which they would not derive benefits.
Avoid Unnecessary Radical Treatments
When a breast cancer is diagnosed at an early stage, the treatment is mainly based on the surgical removal of the tumor and possibly radiotherapy and hormone therapy. “After these therapies, the challenge is to prevent incidence of recurrence in the next 5 to 10 years. Most often, women receive chemotherapy as well to prevent that risk. But scientists have estimated that nearly 70% of women do not need to have chemo when there is no infiltration of the cancerous cells in the armpit lymph nodes (axillary lymph nodes), and so needlessly to suffer the chemotherapy side effects, said Prof. Jean -Yves Pierga, medical oncologist at Curie Institute.
This finding comes after years of study. To better assess the risk of breast cancer recurrence, different teams have studied the genetic characteristics of tumors. With new technology, it is possible to identify genes associated with a high risk of developing relapse and metastases. The discovery allows them to classify women breast cancer in two categories: good and bad prognosis. Patients who fall in the former category could be spared undergoing chemotherapy treatment without prejudice for survival. The second would be offered an optimal personalized treatment to reduce recurrence risk, and thus increase their survival chance. As you know, breast cancer recurrence survival rate is much lower in a tumor detected and treated in early stage.
On February 6 2007 the US Food and Drug Association approved the use of a new genetic test capable of measuring the activity of 70 genes from a tumor sample. Based on an algorithm specific, MammaPrint® can be used to evaluate the risk of a patient to develop breast cancer recurrence. The results can allow the health care provider to adopt and schedule a plan adapted to the patient. With this diagnostic technique, an oncologist can determine “the tumor prognosis based on the size, presence of hormone receptors and histological grade (synthetic indices based on observation under a microscope) of the tumor, lymph node involvement and the age of the patient” said Prof. Pierga.
However, MammaPrint shows better efficacy to predict the absence of recurrences than to predict it. Thus, a result confirming a low risk of relapse proves to be true in 95% of cases, while it is incorrect in about 75% of cases when the test provides a high risk for the tumor to return. Women in the high risk category are twice as likely to experience relapse within five or ten years than those in the low risk group.
MammaPrint® is not the only test that can categorize patients. Oncotype DX © is also used. Recently approved in the United States by the FDA and included in the National Comprehensive Cancer Center Network (NCCN) and the American Society of Clinical Oncology (ASCO) treatment guidelines, Oncotype DX © relies on finding fewer genes (21) and only on hormone sensitive tumors: those with hormone receptor and whose growth is stimulated by natural hormones. But it has the advantage of being used on natural samples used in clinical practice while MammaPrint® requires frozen samples, which implies new structures and practices, “said Prof. Jean-Yves Pierga.
The arrival of these tests in clinical practice creates excitement in the heart of most cancer specialists. But certain professionals such as Professor Pierga remain reasonable, “These tests are based on correspondence of biomolecular results and statistics. Although effective, they are subject of criticism… and must now be validated in large studies”, concludes Professor Pierga.
‘Breast Cancer Recurrence Prevention’
After you have been diagnosed with breast cancer and undergone texts that determine you are at higher risk to see the disease returns, you need to take necessary steps to prevent relapse. Your ‘breast cancer recurrence prevention’ plan must include all aspect of your life, including your Mind Power. That is, you need to not only adopt a healthy lifestyle and diet, but also remain confident you are getting better and better, and you will become cancer-free and never have it again. Some cancer patients do it all but let fear control their mind, thus attract the disease to them. Avoid this mistake. People diagnosed and healed from cancer, you can be one of them.
1 – Nature. 2002 Jan 31;415(6871):530-6.
2 – J Natl Cancer Inst. 2006 Sep 6;98(17):1183-92
3 – N Engl J Med. 2006 Jun 8;354(23):2463-72
4 – N Engl J Med. 2002 Dec 19;347(25):1999-2009
5 – FDA Clears Breast Cancer Specific Molecular Prognosis Test – FDA News – 6/02/2007
6- breastcancer.org: Symptoms and Testing Types for Oncotype DX Test