While some promising new treatments for breast cancer are years away from regular treatment regimens, others are on the market or just around the corner. Similarly, new technologies and equipment, new drugs , advances in the field of genetics or immunotherapy are constantly being discovered and being trialed with a view to producing meaningful health outcomes
The new developments for managing breast cancer described on our web site aren’t on the horizon. They’re here, right now.
SenoClaire 3D Breast Tomosynthesis
More comfort, more clarity, more confidence, less dose
General Electric’s (GE’s) SenoClaire breast tomosynthesis is a three dimensional imaging technology that uses a low dose short x-ray sweep around the compressed breast with only nine exposures that are acquired through a unique step-and-shoot approach. This removes blurring due to tube motion. The result is a superior sensitivity for architectural distortions, microcalification and masses, giving the doctors more clinical confidence while delivering the same amount of dose as a conventional digital mammographic picture of the same view.
The resulting data are processed through complex mathematical reconstruction algorithms into two dimensional images comparable to standard mammograms and also into hundreds of thin slices (or tomograms) that are viewed individually by the reporting doctors.
A major reason for inaccuracies on a conventional mammogram is that cancer can be obscured by normal tissues within the breast. Additionally, normal tissues located in different parts of the breast may become superimposed generating a false suspicion of possible cancer, leading to wasted time, and stress.
This finding was confirmed by a study carried-out at The Strathfield Breast Centre some years ago. However our study described a mammographically negative breast cancer rate of 9% more commonly in younger women. (http://onlinelibrary.wiley.com/doi/10.1111/j.1445-2197.1996.tb01140.x/abstract)
Catherine Tabaka, Chief Marketing Officer, GE Healthcare, Detection and Guidance Solutions summed-up the benefits of this new technology when she said “SenoClaire not only offers patients a new solution to help clinicians better detect breast cancer, but does so with low dose radiation and high image quality.
Not every breast cancer patient needs the same treatment. While chemotherapy and/or radiation therapy are effective treatments, not all women benefit from these modalities equally. In fact, for some women the risks of therapy may outweigh the benefit. Today, doctors are increasingly using genomic testing such as the Oncotype DX® test to help better understand patients’ individual tumour biology to determine the most appropriate treatment after surgery.
Oncotype DX, is a commercial genomic test that analyses the activity of a group of cancer genes in breast tumour tissue. The test provides information regarding the:
- Chance of your breast cancer returning
- Likelihood that you might benefit from chemotherapy in addition to standard hormonal treatment.
Oncotype DX analyses a panel of 21 genes within a tumour to determine a Recurrence Score®. The Recurrence Score is a number between 0 and 100 that corresponds to a specific likelihood of early stage breast cancer recurrence within 10 years of the initial diagnosis. The interpretation of the scores is as follows:
- Recurrence Score lower than 18: The cancer has a low risk of recurrence. The Oncotype DX result also predicts little to no benefit from chemotherapy. Therefore having chemotherapy would mean enduring the unpleasant side effects for no real benefit.
- Recurrence Score between 18 and 31: The cancer has an intermediate risk of recurrence. The chemotherapy benefit is less clear and other factors will need to be considered by your doctor, along with the Oncotype DX result, to determine the most appropriate treatment for you.
- Recurrence Score greater than 31: The cancer has a high risk of recurrence, and the Oncotype DX result predicts a large benefit from chemotherapy. Therefore, adding chemotherapy to your hormone treatment will likely reduce the chance of the cancer recurring.
To be eligible for the test, your early stage breast cancer must be oestrogen receptor positive (ER+ve), negative for human epidermal growth factor receptor (HER2-ve) and be node negative or node positive in post-menopausal women. The test is performed on a small piece of tissue removed during your surgery. Only a health care professional may request this test (your breast surgeon or oncologist) and you need to be aware that the cost of this test is in the region of $(AUS) 4,500.
Oncotype DX is performed by Genomic Health in its CLIA-certified, CAP-accredited reference laboratory in the USA. Results are available within 3 to 4 weeks.
The Oncotype DX test has been evaluated in numerous clinical studies involving more than 6000 patients. Since becoming available in 2004, more than 440,000 Oncotype DX test have been requested by nearly 20,000 doctors (on behalf of their patients) in more than 70 countries.
Oncotype DX test results are not enough on their own to guide treatment. Your doctor will consider your test score along with other aspects of your cancer and your health to decide on the best treatment. These factors can include the tumor size and grade, the number of hormone receptors in your cancer (many or just a few), and your age.
Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. Paik S1, Tang G, Shak S, Kim C, Baker J, Kim W, Cronin M, Baehner FL, Watson D, Bryant J, Costantino JP, Geyer CE Jr, Wickerham DL, Wolmark N. J Clin Oncol. 2006 Aug 10;24(23):3726-34.
The impact of a genomic assay (Oncotype DX) on adjuvant treatment recommendations in early breast cancer. Richard H de Boer, Caroline Baker, David Speakman, Calvin Y Chao, Carl Yoshizawa and G Bruce Mann. Med J Aust 2013; 199 (3): 205-208.
Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Albain KS; Barlow WE; Shak S; Hortobagyi GN; Livingston RB; Yeh IT; Ravdin P; Bugarini R; Baehner FL; Davidson NE; Sledge GW; Winer EP; Hudis C; Ingle JN; Perez EA; Pritchard KI; Shepherd L; Gralow JR; Yoshizawa C; Allred DC; Osborne CK; Hayes DF; Breast Cancer Intergroup of North America. Lancet Oncology. 11(1):55-65, 2010 Jan.