Health Team

Chemotherapy isn't right for every patient

Posted December 11, 2009 1:27 p.m. EST
Updated December 11, 2009 8:03 p.m. EST

— Many cancer patients chose chemotherapy, yet only four out of 100 women with early-stage breast cancer will benefit from the treatment.

A special test can help patients determine if chemotherapy is right for them.

Ley Mitchell Colpitts, 41, had a choice of treatment options after finding a lump during a self breast exam and getting a diagnosis of breast cancer. She had a mastectomy and reconstructive surgery, then had to decide between chemotherapy and hormone therapy.

Duke University Medical Center breast surgeon Dr. Lee Wilke took samples from her tumors and sent them to genomic health labs for Oncotype DX testing.

"There are times when we use testing such as Oncotype DX, which is a genetic test using 21 genes, to further characterize a breast cancer," Wilkes said.

The American Society of Clinical Oncology issued new guidelines recommending the Oncotype DX test for all estrogen-receptor-positive and node-negative breast cancer patients. It reveals patients at high risk of recurrence who need chemotherapy.

The test has been evaluated in multiple independent students involving more than 3,000 patients. Results have been published in the New England Journal of Medicine and the Journal of Clinical Oncology.

"This is the first really important test, in addition to our standard pathological review, that allows to further individualize care," Wilke said.

Colpitts tested as low risk for recurrence, and she wouldn't benefit from the debilitating rigors of chemotherapy. She got hormone treatment alone.

Colpitts said she is thankful her care was tailored to her cancer and allowed her to return to a busy but enjoyable work and family life.

"Even though chemotherapy is wonderful for some people, it would have been really terrible for me to find out that it really wasn't doing me any good," she said.