Health watchdog backs wider use of tests to profile breast cancer tumours

The tests can help doctors and patients decide whether chemotherapy is really necessary to prevent cancer from returning.

More people with breast cancer could be spared chemotherapy after a health watchdog recommended the wider use of tumor profiling tests.

The tests, which provide information about the genetic makeup of breast cancer tumors, can help doctors and patients decide whether chemotherapy is really necessary to prevent cancer from returning.

The National Institute for Health and Care Excellence (Nice) supported the wider use of three tumor profiling tests (EndoPredict, Prosigna and Oncotype DX) by the NHS.

These may guide the treatment of postmenopausal women, and men, with estrogen receptor (ER) or progesterone receptor (PR)-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer with one to three positive lymph nodes.

The test results, returned within days, help predict the risk of cancer returning after surgery, when combined with other factors such as tumor size.

If the results of tumor profiling tests indicate a low risk of cancer recurrence, patients may choose not to undergo chemotherapy, which can have serious side effects.

Mark Chapman, interim director of the Health Technologies Program in Nice, said: “Choosing to undergo chemotherapy is a difficult decision if you don’t have all the information.

“A test that can help predict the risk of breast cancer spreading should be considered an important step forward for patients.

“Our committee heard compelling patient testimony outlining the significant emotional and psychological strain associated with making this decision.

“Receiving chemotherapy will be the right choice for some, but for others they will not have to deal with the side effects that come with the treatment.”

Tumor profiling tests are already recommended to guide chemotherapy decisions in people with estrogen receptor ER-positive, HER2-negative, lymph node-negative early breast cancer.

But figures suggest another 3,000 patients or more could benefit from an increase in testing.

Professor Simon Holt, from Swansea University and Prince Philip Hospital in Wales, said the use of Oncotype DX in particular will “reduce suffering and discomfort” by sparing up to 85% of eligible people unnecessary chemotherapy.

“It also significantly reduces the cost of treatment so that NHS resources can be reallocated to other medical priorities,” he said, adding that using the test gave doctors and their patients “much more confident in their chemotherapy decisions” .