Breast cancer test to spare thousands from chemotherapy: Pioneering treatment to be available on the NHS from April
Oncotype DX test studies genes found in tissue removed during surgery
Indicates how likely recurrence is and whether chemotherapy is beneficial
Expensive test recommended by health watchdog Nice 18 months ago
Only 20% of early-stage breast cancer patients believed to benefit from chemotherapy
By JENNY HOPE MEDICAL CORRESPONDENT FOR THE DAILY MAIL
PUBLISHED: 19:44 EST, 5 February 2015 | UPDATED: 03:08 EST, 6 February 2015

A new test which could spare thousands of women with breast cancer from having needless chemotherapy is to be available on the NHS.

From April, hospitals in England can join a scheme that has cut the price of the Oncotype DX test.
It was recommended by the health watchdog Nice 18 months ago but the cost of Ł2,000-Ł2,500 per patient deterred most NHS hospitals from using it.


A new test which could spare thousands of women with breast cancer from having needless chemotherapy is to be available on the NHS

Genomic Health UK, which has not disclosed the new price, announced yesterday that the test was now an option for clinicians and patients in England.

It looks at genes found in breast tissue removed during surgery and indicates how likely breast cancer recurrence is and whether chemotherapy will actually benefit the patient.

An estimated 10,000 women each year who are at most risk of their cancer returning could be eligible for the test, and its use – when it is not clear whether a patient will benefit from chemotherapy – could mean some avoid the treatment.

Research suggests only around 10 to 20 per cent of patients with early-stage breast cancer benefit from chemotherapy.

Professor Kefah Mokbel, lead surgeon at the London Breast Institute, said ‘This is great news. For too long we’ve had to treat too many women in a blanket fashion – whatever their tumour is like, they are offered chemotherapy.

‘This is a real step forward and it’s fantastic news for the NHS. Around 25 per cent of women who have breast cancer will be eligible and some will be able to safely avoid chemotherapy.’


An estimated 10,000 women each year who are at most risk of their cancer returning could be eligible for the test and its use could mean some avoid the treatment

Professor Mokbel said younger women in their 40s often have chemotherapy to maximise their chances, when older women with similar characteristics might not get it. He said: ‘These younger women will get a more accurate picture of their risk.’ The test analyses a group of 21 genes found in breast cancer and results are reported as a ‘score’ between 0 and 100.

This score indicates how likely the cancer is to return and whether chemotherapy will benefit the patient.
The lower the score, the less likely the cancer is to come back and treatment is normally withheld at scores below 18. The higher the score is above 31, the more likely the cancer is to come back. If the figure is between 18 and 31, the benefit of chemotherapy is less clear.

Professor Mokbel said scores in that range mean a woman will need to discuss the pros and cons with doctors.



Professor Karol Sikora, chief medical officer of Cancer Partners UK, has visited the California-based facilities where the tests are sent for analysis, and said it was a highly organised business with test results coming back in seven days.

He said: ‘There will be definite benefits for some women. In around 80 per cent of cases chemotherapy makes no difference to the outcome.’

Dr Emma Pennery, clinical director from Breast Cancer Care charity, said the test would be invaluable.
She said: ‘Patients can suffer from debilitating effects for a long time and it can have a real impact on quality of life.

‘This test could enable some to avoid the brutal side-effects of chemotherapy without compromising their survival.
‘Every year in the UK 55,000 women are diagnosed with breast cancer and treatment decisions can be extremely difficult. It is incredibly important that these women have all the information to help them make the best choice for them.’

Dr Andrea Pithers, of Genomic Health UK, said: ‘We will work with local hospitals to facilitate quick and equitable access throughout the country.’