Thousands of Canadian breast cancer patients could avoid chemo, according to study

Results are expected to spare patients from having to undergo rounds of chemotherapy

Lisa Freedman, who is now cancer-free, poses for a photo outside her Toronto home on Friday, June 8, 2018. (Tijana Martin/The Canadian Press)

When Lisa Freedman was diagnosed with breast cancer, a genetic test of her tumour suggested chemotherapy would have no effect on the risk of recurrence, allowing her to safely skip the treatment and its dreaded side-effects.

“When the test came back, it showed that I would have a 13-per-cent chance of recurrence if I had chemo and a 12-per-cent chance if I didn’t have chemo,” said the Toronto lawyer, 61.

“So that became an easy no-chemo decision,” said Freedman, who has been cancer-free for two years.

A recently published U.S.-led study of more than 10,000 women whose tumours were tested determined that most patients with early-stage estrogen-positive breast cancer and no lymph-node spread should be able to avoid chemo and be treated with surgery, radiation and a hormone-blocking drug like tamoxifen alone.

The study is the largest ever performed looking at breast cancer treatment, and its results are expected to spare thousands of women in Canada each year from having to undergo rounds of chemotherapy and its harsh side-effects.

Funded by the U.S. National Cancer Institute, with additional funding from the Canadian Cancer Society Research Institute, the research looked at women with breast cancer with an intermediate risk of recurrence, based on their scores from the genetic test.

READ MORE: Centre gives breast cancer patients new outlook on life

Previously, scores from the US$3,000 Oncotype DX test, used since 2004, allowed doctors to sort out women at high risk and low risk of recurrence to determine whether they would benefit from chemotherapy.

But women with in-between scores fell into a grey area — should they get chemo or not?

That’s what the study, which began in 2006 and included 10,253 women aged 18 to 75, set out to determine, with participants randomized to receive chemo plus a hormone-dampening drug or that medication alone.

The results were stunning.

After nine years, the findings put the women virtually in a dead heat: more than 90 per cent of those in both groups were still alive, while almost 85 per cent in each were free of recurrence.

Researchers concluded that almost 70 per cent of women with this form of breast cancer could safely dodge chemotherapy.

“(For) women in-between, where there was some uncertainty, I think this study is very reassuring that for the majority of them we don’t have to give chemotherapy,” said Dr. Andrea Eisen, an oncologist at Sunnybrook Health Sciences Centre in Toronto, where 56 patients took part in the multi-centre trial.

The results represent an evolution in how this most common form of breast cancer will be treated in the future, agreed Dr. David Cescon, a breast medical oncologist and researcher at the Princess Margaret Cancer Centre.

“There have been other studies that have contributed, other supportive information along these lines, which have allowed us to avoid chemotherapy, particularly for women in the lower end of this middle-risk group,” he said.

“But this will allow us to make those recommendations with more confidence, particularly in the higher end of the middle range for older women.”

For Freedman, being told she didn’t need chemo was welcome news, though she admitted that the time from diagnosis to having a surgical lumpectomy and the tumour test moved so quickly, she ”never had to go through that whole angst.”

Still, she was well aware of the horrors of chemo and had wondered how she would be able to work through the treatment regimen.

“I kind of visualized myself lying on the floor in the bathroom throwing up, with my hair falling out and trying to get my strength back,” Freedman said.

“So when (the oncologist) said there was absolutely no need for chemo, it was a sigh of relief, almost tears of relief.”

Eisen said there has been an ongoing shift over the decades in how breast cancer is treated.

“Everybody used to have a mastectomy, then we realized doing a lumpectomy and radiation was essentially just as good,” she said.

“And then everybody used to have an ancillary lymph-node dissection, so removal of a lot of lymph nodes under the arm. And then we realized that a smaller operation called a sentinel node biopsy could give in most cases equivalent information.

“So now this is the first time we’re really looking at drug treatment … That’s kind of a signal of how good the outcomes are becoming, that we’d look at taking away treatment, rather than giving more.”

Sheryl Ubelacker, The Canadian Press

Just Posted

East Kootenay illicit drug overdose deaths lowest in B.C.

Local expert credits harm reduction efforts; declares support for legalization of opioids

Donations pouring in for injured Fernie man

GoFundMe page for Rick Kennedy reaches $17,639

Fernie’s Sam Goodison representing Alberta at Canada Winter Games

Fernie’s Sam Goodison will be representing Alberta at the upcoming Canada Winter… Continue reading

RDEK takes steps towards reducing carcass pit use

The first step towards addressing the issue of carcass pits in the… Continue reading

Ghostriders head coach Jeff Wagner commits to another two years

Fernie Ghostriders head coach Jeff Wagner has committed to another two years… Continue reading

B.C. students win Great Waters Challenge video contest

Video, mural and song about saving the salmon claims the top prize

GALLERY: Fernie Ghostriders get their home game mojo back

Riders post 6-1 win over Columbia Valley Rockies; prepare for playoffs

James says B.C. budget puts priorities on NDP’s poverty, environment plans

She said she expected the government’s poverty reduction and climate change strategies to be priorities in the budget

PHOTOS: Day 1 of the 2019 Canada Winter Games in Red Deer

Games kicked off in Red Deer this week

Ammonia leak shuts down curling club in Nelson

It’s not yet clear when the leak was detected

Pavelski’s 31st goal helps Sharks top Canucks 3-2

Vancouver one point out of second NHL wild-card spot

Columbia Valley RCMP searching for misisng person

Police ask for help in finding Elizabeth Stewart, who hasn’t contacted family since Jan. 14

Eight cases of measles confirmed in Vancouver outbreak

Coastal Health official say the cases stem from the French-language Ecole Jules Verne Secondary

Ontario police field complaints over Amber Alert for missing girl, 11, found dead

Some said the Amber Alert issued late Thursday for Riya Rajkumar disrupted their sleep

Most Read