Breast Cancer Treatment: It’s No Longer One Size Fits All

This article was first published as “An Alternative to Chemo” in The Jewish Week.

RNA extraction at Genomic Health

Both Jamie Gurvitch and Helene Schonbrun, each of them a working mom with three children, were diagnosed with breast cancer while in their 40s. Gurvitch, now 47, was told she had stage 1 invasive carcinoma in 2009. Schonbrun, now 45, was initially diagnosed at age 41 with ductal carcinoma in situ (DCIS), also known as stage 0 breast cancer. But upon further testing, it turned out that she, too, had a malignant tumor.

It used to be that when women like Schonbrun and Gurvitch were diagnosed with breast cancer, they would automatically undergo chemotherapy. They would hope for the best, not knowing whether they were really better off subjecting their bodies to the cancer cell-killing drugs, or whether it was better to forgo the chemotherapy and just take anti-estrogen therapy, like Tamoxifen.

Fortunately Schonbrun, who lives in White Plains, and Gurvitch, who moved several years ago to Boynton Beach, Fla., from New Rochelle, were able to avail themselves of a genomic test, called Oncotype Dx, that helped them and their doctors make that difficult treatment decision.

It used to be that the Oncotype Dx assay was only indicated for women with N- (node negative), ER+ (estrogen receptor positive – the most common kind of breast cancer) stage 1 and 2 breast cancer, but as of December 2011, it is now available for use by women with DCIS, to help them decide whether to undergo radiation treatment or not. While chemotherapy is still utilized in cases of invasive breast cancer, radiation is now the standard treatment for DCIS, which is contained within the milk duct and has not spread further into the other breast tissue.

 Since 2004, more than 250,000 patients worldwide have benefited from breast cancer and colon cancer Oncotype Dx assays, both of which examine tumor tissue at a molecular level to predict the chances of the cancer recurring, or metastasizing. Unlike the test for the BRCA gene mutation, which influences the risk that a woman might develop breast cancer over the course of her lifetime, Oncotype Dx examines the unique genetic makeup of a woman’s tumor.

Click here to read more.

© 2012 Renee Ghert-Zand. All rights reserved.

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