New breast cancer test could reduce chemotherapy

A new breast cancer test could help some patients avoid unnecessary chemotherapy.

The test looks at genes in tumour tissue. It helps doctors estimate the risk that breast cancer will return after treatment. Patients with a low risk score may be able to receive hormone therapy without chemotherapy.

The research focused on people with hormone positive breast cancer. This is the most common form of breast cancer. More than 4,000 patients took part in the study.

One group received chemotherapy and hormone treatment. Another group received the gene test. Patients with a high risk score still received chemotherapy and hormone treatment. Patients with a low risk score received only hormone treatment.

The results were close. After five years, almost 95 percent of the patients who received chemotherapy were alive and cancer free. In the low risk group that did not receive chemotherapy, the figure was almost 94 percent.

That suggests some patients may be able to safely avoid chemotherapy if the test shows a low risk of the cancer returning.

This matters because chemotherapy can have serious side effects. These can include hair loss, nausea, fatigue, memory problems and long term health effects. For some patients, avoiding chemotherapy can mean a better quality of life during and after treatment.

Gene tests are already used in the Netherlands to help decide follow up treatment for breast cancer. The important new point is that the latest research also shows promising results for younger women between 40 and 50.

That age group is important because some existing tests are mainly used for women over 50. If the new approach is adopted more widely, it could help younger patients make more personal treatment decisions.

The development is a useful example of how Dutch cancer care works. Treatment decisions are often based on national guidelines, hospital teams and risk assessment. Patients are expected to discuss the benefits and downsides of treatment with their doctor.

The test does not mean chemotherapy will disappear. It also does not mean every patient can skip it. Cancer treatment remains personal, and risk differs from person to person.

The next question is whether the test will be used more often in Dutch hospitals and whether it will be reimbursed. Without reimbursement, access may remain limited.

Still, the direction is clear. Cancer care is becoming more tailored. Instead of giving the same heavy treatment to everyone, doctors are trying to identify who really needs it and who may safely avoid it.