How Has Genomic Testing Impacted the BC Treatment Landscape?



Michael D. Alvarado, MD: We’ve been using the Oncotype DX Breast Recurrence Score now for almost 15 years, and sometimes I think people forget that 15 years ago, women who had breast cancer and were ER [estrogen receptor]-positive with no lymph node involvement and had at least a 1-cm tumor almost always got offered chemotherapy. If you talk to young oncologists now or those who are training, they wouldn’t even believe that you’re saying that because it has dramatically changed in these last 15 years. We are definitely individualizing therapy. Women who were almost always overtreated for estrogen receptor—positive breast cancers now are getting the recurrence score to identify that small proportion who actually benefit from chemotherapy.

It’s changed a number of people’s lives. No chemotherapy, no adverse effects from chemotherapies, no hair loss, for example, and no losing time with their families or at work. Women who have things to do with their lives, just like everybody else in the world, can now have surgery and go on hormone therapy and not have to have 5 months of chemotherapy. I think we really forget the impact that the genomic assay, the recurrence score, has had on these women. We’re talking about literally thousands and thousands of women who don’t have to have chemotherapy—maybe 50,000 or 100,000 women—over the last 15 years. It really is remarkable what we’ve done over this time, and I think we sometimes have to sit back and realize how far we’ve come with that genomic assay.

Transcript Edited for Clarity

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