New test allows breast cancer patients to safely skip chemo
Administration, The When The Of Test Included Walshe And "we Said: Janice There " Price About €3m Reduction Chemotherapy A Saved Had Was We In Professor 58%
A breast cancer patient who availed of a new test allowing her to safely skip chemotherapy has hailed the new technology, saying it gave her time and better quality of life.
Geraldine, age 62 now and living in the southeast, is one of 480 women in Ireland who avoided chemotherapy after genetic testing identified they could safely rely on other treatment instead. New analysis of the test's impact over 10 years also suggests they saved the HSE €3m.
Geraldine, who asked for her surname not be used, is now back at work as a nurse, and “feeling grand” she said.
A mammogram in March 2022 put her on the path to St Vincent’s hospitals. “I had a very small tumour,” she said. “Then within two weeks I met a surgeon who was plotting the dates for surgery, it was so fast.”
Options were surgery, chemotherapy, radiotherapy and hormone-based therapy.
“She was pretty sure I was going to be having three of those, the only thing she wasn’t sure of whether I would need chemotherapy or not,” Geraldine said.
Results from an Oncotype DX® test would decide this. So during surgery in late April, a small part of the tumour was sent to America for testing.
“So you get a score and it’s the likelihood of recurrence is what they’re checking; with or without chemotherapy,” she said.
“If you have a lowish score, then the chances of the recurrence are much lower. If you have a higher score than the chances of recurrence without chemotherapy is higher.”
Some weeks later, she met oncologist Professor Janice Walshe. On being told chemotherapy was not recommended, Geraldine said:
She was aware that while chemotherapy is necessary for some cancers, it is not pleasant. “Chemo is a toxin going into your body, nobody who has chemo has ever said ‘I didn’t mind that, it was grand’, there are so many side-effects,” she said.
She added: “It just completely disrupts your life” and requires a long rehabilitation. Her care involved surgery, radiotherapy and hormone treatment. “I have been so fortunate,” she said, describing the care as “seamless”.
Oncotype DX® tests were approved for HSE funding in treatment for node negative breast cancer patients in 2011 and for node positive(N1) breast cancer in 2020.
Prior to that approval, doctors such as Prof. Walshe could apply for compassionate funding.
She analysed the impact of these tests for women across five centres between 2012 and 2022, including St Vincent's hospitals and Cork University Hospital.
“The results were stark, that we had a 58% reduction in chemotherapy administration, and when we included the price of the test there was about €3m saved. That is substantial,” she said.
“So we had 828 patients tested altogether, and 480 of them avoided chemotherapy.” She added: “This is really successful.”
These results are presented this week at the San Antonio Breast Cancer Symposium by Dr Iseult Browne. Studies previously showed benefits for women before and after their menopause, but not for all younger women.
“So we need to define who are those pre-menopausal women who benefit, we don’t have that result so we need to do further study,” Prof. Walshe said.