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Chemotherapy for breast cancer is not always useful

Chemotherapy for breast cancer is not always useful

New test procedure can avoid unnecessary chemotherapy for breast cancer

Breast cancer is the most common form of cancer in women and is still treated with a combination of surgery, radiation and chemotherapy as standard. However, according to current scientific knowledge, chemotherapy hurts many patients more than it actually uses, reports the "Norddeutsche Rundfunk" (NDR).

Chemotherapy is not always the method of choice Given the side effects of chemotherapy, its use in numerous breast cancer patients is rather counterproductive and, when in doubt, leads to a deterioration in health. According to the "NDR", the improved early detection has led to breast cancer (breast cancer) "often being discovered at a very early stage today". According to the current state of research, chemotherapy only makes medical sense if the tumor has already spread to the lymph nodes. Nevertheless, most patients receive some kind of preventive chemotherapy, even if the cancer tumor was discovered early and surgically removed.

Breast cancer most common tumor in women In western industrialized countries, breast cancer is the leading cause of death in women between the ages of 30 and 60, according to the World Health Organization (WHO). The number of diagnoses has increased steadily in recent years, but mortality has decreased. Today, more than 70,000 new cases are registered in Germany every year, and almost 18,000 patients strive for the consequences of their illness. Every eighth woman in Germany will develop breast cancer at some point in her life. In the past few decades, early detection has improved significantly, not least because of the extensive mammography screening and the improved diagnostic procedures, which means that the tumors are often discovered at a very early stage. For cancer experts worldwide, the question arose whether the previous treatment with surgery, followed by radiation and chemotherapy for several weeks, still meets the requirements. Although two thirds of the patients can be cured on the basis of this treatment, chemotherapy may not have a decisive influence on the healing success of early breast cancer.

Chemotherapy only makes sense after cancer has spread Recent studies have concluded that the risk-benefit assessment only justifies chemotherapy for breast cancer if it has also spread to the lymph nodes. Contrary to these findings, in practice, however, most patients are recommended preventive chemotherapy for early breast cancer. The difficulty lies in the assessment of the risk of metastasis, so that chemotherapy is often used. To remedy this problem, researchers worldwide are working on new test methods that can be used to determine the risk of lymph node involvement. As the "NDR" reports, the scientists use the "protein uPA (urokinase-type plasminogen activator) and its counterpart PAI-1 (plasminogen activator inhibitor 1)" to determine the risk of metastasis. The proteins can be checked on the basis of a tissue sample, which is taken during the surgical removal of the tumor, according to the experts in an interview with the "NDR". A low uPA / PAI-1 content in the tumor tissue suggests that there is a low risk of relapse for the patients.

The affected breast cancer patients with a low risk of relapse could "be spared psychologically and physically stressful accompanying chemotherapy without increasing the risk of falling ill again", the statement in the "NDR" report. However, the tissue sample must already be taken during the operation and afterwards this possibility of risk assessment is no longer applicable. So far, the test has not been included in the service catalog of the statutory health insurance companies, but some insurance companies are already covering the costs of around 300 euros.

Oncotype DX test procedure to determine cancer relapse risk Another approach to determine cancer relapse risk is followed in the ADAPT study. In the future, this should help to optimize the therapies of breast cancer patients and to avoid unnecessary chemotherapy. For this purpose, around 4000 test persons between the ages of 18 and 75 with hormone-receptor-positive breast cancer without lymph node involvement are examined throughout Germany. The individual breast cancer relapse risk is determined by analyzing 21 genes from a tissue sample. The samples are then shipped to a US laboratory. If a low risk is determined, chemotherapy may be dispensed with, as Prof. Dr. Tjoung-Won Park-Simon, deputy director of the clinic for gynecology and obstetrics, head of gynecological oncology reports to NDR magazine. The procedure is not only offered in the Jerusalem Hospital in Hamburg, but also in other clinics in Germany. However, the test called Onkotype DX is not covered by the statutory health insurance companies, but has to be paid for according to the patient's annual income. The test procedure costs between 150 and 300 euros. (fp)

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