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The test that can save some breast cancer patients chemotherapy - voila! health

2023-12-04T07:08:11.462Z

Highlights: The test that can save some breast cancer patients chemotherapy - voila! health. Breast cancer is the most common cancer among women. According to data from the Ministry of Health, in 2019, 5,316 women were diagnosed with breast cancer in Israel, and at the same time 1,085 women died from the disease. The earlier the disease is detected, the greater the chances of recovery, says Dr. Maayan Geller, a senior oncologist at the Ziv Medical Center's Cancer Treatment Center in Safed.


Breast cancer is the most common cancer among women. Oncotest's "breast onctape" test can help some patients diagnosed with breast cancer


According to data from the Ministry of Health, in 2019, 5,316 women were diagnosed with breast cancer / ShutterStock in Israel

One in eight women in the Western world and in Israel is liable to develop breast cancer, and every woman – even without risk factors – has a 14% chance of being diagnosed with this disease. How common is it? According to data from the Ministry of Health, in 2019, 5,316 women were diagnosed with breast cancer in Israel, and at the same time 1,085 women died from the disease. According to the World Health Organization, in 2020, 2.3 million women worldwide developed breast cancer.

"Unfortunately, sometimes the fear of cancer treatment, and chemotherapy in particular, may cause women not to go get tested. In many cases, women are not aware that there is a possibility that they will not need chemotherapy at all, and the very news of cancer creates a connotation for them of the side effects of the treatment - including hair loss," says Dr. Maayan Geller, a senior oncologist at the Ziv Medical Center's Cancer Treatment Center in Safed. "Breast cancer is a very common disease and the earlier the disease is detected, the greater the chances of recovery. According to her, thanks to screening tests for early diagnosis, there has been a significant decrease in mortality rates from the disease over the years: in 2019, about 69% of patients diagnosed with breast cancer were diagnosed at an early stage, about 28% were diagnosed with locally advanced disease, and only about 3% were diagnosed with metastatic disease.

Early breast cancer treatment is based on personalized medicine/ShutterStock

The side effects of chemotherapy are numerous and can have short- and long-term effects

How to choose the treatment?

Treatment for early breast cancer is based on personalized medicine. First, a basic pathological examination is performed, which includes examining the histological type of the tumor, the degree of tumor malignancy (grading), as well as biological characteristics of the tumor, such as the level of expression of receptors for the hormones estrogen and progesterone and the level of expression of the HER2 receptor. Based on these results, the patient's tumor can be classified into different types of breast cancer.

"Most patients (about 70 percent) have positive and negative hormone receptor expression levels for HER2. In these patients - if possible - surgery is first performed to remove the tumor, either by partial or complete mastectomy. After surgery, it is necessary to decide on the type of complementary/prophylactic (adjuvant) treatment, whether complementary chemotherapy followed by prophylactic hormone (endocrine) therapy is required, or whether hormone therapy alone is sufficient in order to reduce the risk of recurrence. In order to make a decision about the need for additional chemotherapy treatments, we use genomic testing such as breast oncotype," adds Dr. Geller. "It is important to note that for most patients after surgery, whether it is a partial or complete mastectomy, local radiation therapy is also needed, regardless of the characteristics of these receptors."

The side effects of chemotherapy are numerous and can have short- and long-term effects. These symptoms include, but are not limited to, decreased immune function, weakness, nausea and vomiting, gastrointestinal changes that can cause diarrhea or constipation and sores in the mouth. In addition, there may be damage to nerve endings, damage to nails, dry mouth and eyes, and hair loss. "As I have discovered, breast cancer patients are very afraid of chemotherapy. Sometimes the news of the need for chemotherapy is more difficult for them than the news they received of being diagnosed with breast cancer," emphasizes Dr. Geller. "However, care must be taken to detect early and not avoid any treatment that is required. It is important to note that chemotherapy is very critical in some patients. Although there are cases where the side effects from chemotherapy are not simple, they are often well manageable and go away after the end of treatments," emphasizes Dr. Geller.

Breast oncotype testing has been around for two decades, and is used in all hospitals in Israel/ShutterStock

Even after a decade - the cancer did not return

"Breast oncotype is a genomic test that examines the expression of 21 genes in tumor tissue. For this purpose, the tumor tissue of the patients who were removed by surgery or biopsy is taken, and the examination provides us with additional information with very important implications for the disease," says Dr. Geller.

"The test results provide an index of recurrence of the disease Recurrence Score. Pronounced as a continuous number between 0-100. This measure is translated into a percentage chance that the patient's disease will recur metastatic in the next 9 years, given that the patient is taking prophylactic hormone therapy (for 5 years)," explains Dr. Geller. "The second figure, which is important in terms of treatment decision, shows us to what extent, if at all, there is an advantage in supplementing chemotherapy in reducing the risk of metastatic disease recurrence."

Breast oncotype testing has been around for two decades, and has been used in every hospital in Israel and is an important tool for doctors and patients in making the decision to continue treating cancer.

The vast experience accumulated and supporting studies found that 97.4% of women who received a recurrence index score in the range of 0-25, 25 and did not receive chemotherapy - their disease did not return even after ten years and is no different from that of women with the same score (0-25) who received chemotherapy.

In addition, studies have found that among women under the age of 50 (before menopause) there is an advantage to supplementation with chemotherapy even in cases where a result of 0-25 was obtained when there is no involvement of the disease in lymph nodes. In fact, this group had a small but significant advantage for chemotherapy as early as a score of 21 and for those with a high clinical risk as early as a score of 16. In addition, among young women who have disease involvement in 1-3 glands, very small benefit of chemotherapy administration was found in reducing disease recurrence by about 2.4% even in the 0-25 grade range.

"This is the test with the most extensive validity of the tests currently available, which shows that the test is both predictive of the likelihood of disease recurrence and predicative for response to chemotherapy," explains Dr. Geller. "It is important to emphasize that the test is suitable for some cases and not for all patients. When making a treatment decision, the medical staff must examine the involvement of the disease in the lymph nodes, and the patient's age, her condition in relation to menopause (menopause or active menstruation) and her genetic background. The examination is given as part of the health plan baskets to the appropriate patients."

"I recommend that every woman actively self-examine"/ShutterStock

"I was very worried about chemotherapy,"

Sanaa Abu Saleh (53) from Majdal Shams was diagnosed with breast cancer about a year and a half ago.

"Until I was diagnosed, I had no symptoms and no family history. At the HMO, they referred me for periodic screening tests and promised answers within ten days," Abu Saleh says. "To my surprise, I received a phone call the next day asking me to report for another check-up," she recalls. "At that point, I began to understand that there was probably a suspicion of an improper finding. I was referred for a biopsy, after which I received the bitter news that it was a cancerous tumor in both breasts."

Abu Saleh was in complete shock. "I asked myself why me? Why now? What do I do? And how do I cope?" she recalls. "As the hours and days passed, I believed the end would be good. I told myself that no matter what price I had to pay, I would do anything to get better. I believed in medicine and the medical staff, I believed in myself, and I had to convey optimism to everyone around me," she adds. "Of course there were moments, especially when I was alone, when I was scared and even crying."

After a series of extensive examinations and clarifications, Abu Saleh performed a partial bilateral mastectomy of the breasts, in addition to the removal of lymph nodes from the armpit on both sides. "After the operation, I was supposed to receive complementary treatment with chemotherapy, but a breast oncotype test changed the picture," says Abu Saleh.

Sanaa admits that she feared the chemotherapy, with all that it entailed, and especially the side effects such as weakness and hair loss. "Even though I was willing to go through any treatment to recover, it wasn't easy to think I would need chemotherapy," she says. "At the meeting with the oncologist after the surgery, I was presented with the option of a genomic test that could better characterize the disease and help decide whether chemotherapy is also needed or not," she recalls. "Of course I immediately agreed."

Fortunately, the results of Abu Saleh's breast oncotype test were good, so Sanaa and the attending physician decided that chemotherapy was not needed and that hormone therapy and radiation therapy would suffice.

"Although I was willing to receive any treatment I needed, no matter what the cost, to cure the disease, I also knew that chemotherapy could be the hardest," Abu Saleh says. "Of course, after receiving the findings, I was very happy, and I felt very relieved. Almost 18 months have passed since the diagnosis and my condition is excellent, thank God. I am under close medical observation once every two months," she concludes.

"I recommend that every woman actively perform a self-examination or with the help of community doctors, and of course follow up and be aware of family history," concludes Dr. Geller. "The basket of treatments that exist today and the knowledge we have accumulated to treat allow us to greatly increase the chances of a cure."

In association with Oncotest

  • More on the subject:
  • Breast cancer

Source: walla

All life articles on 2023-12-04

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