Steve Lo, MD, Hematology & Oncology, Carl & Dorothy Bennett Cancer Center

Terrific news! More and more women with early-stage breast cancer no longer need aggressive chemotherapy and can be spared the difficult side effects. Stamford Health’s Carl & Dorothy Bennett Cancer Center participated in the clinical trial TAILORx which was reported in the recent national meeting of the American Society of Clinical Oncology. This study showed that if a woman over age 50 with an estrogen-receptor-positive breast cancer (breast cancer with proteins in or on cells that attach to the hormone estrogen) displays an intermediate cancer recurrence score of 11-25 based on the genomic test OncotypeDx, then she will not benefit from chemotherapy. The only systemic therapy she needs is the much more easily tolerated endocrine, anti-estrogen therapy.

It is estimated that this study will spare 60,000 women per year from receiving chemotherapy. Although this study applied only to patients who do not have axillary (armpit) lymph node involvement (the presence of cancer cells in the surrounding lymph nodes), there are data that the OncotypeDx is applicable to women with lymph node positive disease in determining those who need chemotherapy and those who do not.

It is so important to get a second oncologic opinion, especially if your oncologist recommends chemotherapy. At the Carl & Dorothy Bennett Cancer Center, we have seen many patients for 2nd or even 3rd opinions who have been recommended aggressive chemotherapy, and we felt strongly based on their OncotypeDx that they do not benefit from chemotherapy. As a member of the Dana Farber /Brigham and Women’s Cancer Care Collaborative, we present many of our patient cases at our weekly tumor boards to confirm our recommendations.

Although the use of chemotherapy is shrinking, there is still a role for chemotherapy for women with high risk cancers or young women with intermediate risk cancer. As always, it's a case-by-case basis and one size no longer fits all. The members of the Bennett Cancer Center are dedicated to tailoring the therapy to the individual patient.