Prognostic tests can help determine the most appropriate course of treatment for each patient.

Written by Editorial Team | Updated : February 23, 2022 3:01 PM IST

Over the last two decades, breast cancer treatment has evolved tremendously. Oncologists, scientists, and researchers not only have a better understanding of the disease but have also found new methods that improve patient outcomes and decrease the need for chemotherapy.

Breast cancer is now accepted as a heterogeneous disease with various molecular subtypes. Hence, the aggressive chemotherapy treatment is no longer the required course of treatment for certain subtypes of the disease.

Some types of breast cancer cells need estrogen or progesterone to grow and thus express receptors for these hormones. This hormone receptor-positive subtype of breast cancer constitutes about 70-80 per cent of all breast cancers diagnosed. Also Read Mahima Chaudhry Fighting Breast Cancer, Anupam Kher Shares Emotional Video - WATCHNew Drug Brings Hope To Metastatic Breast Cancer Patients, Ups Their Survival RateBeware! Cancer Can Trigger Diabetes, Stop Insulin Production In Your Body More News

Patients diagnosed in the early stage with hormone receptor positive, HER2/neu negative disease may not have any benefit from chemotherapy and can be saved from the devastating side effects of the aggressive treatment. Adjuvant hormone therapy can be the optimal plan of care for patients with hormone receptor-positive breast cancers

According to the vast data obtained from lakhs of patients, it has been concluded that only 15 per cent of the early-stage hormone-positive, HER2/neu negative breast cancer patients benefit from chemotherapy. Therefore, chemotherapy can be successfully spared for a huge majority of the patients.

Breast cancer treatment has moved away from a one size fits all approach. In the case of early-stage breast cancer patients, oncologists are increasingly opting for personalized treatment approaches to ensure that no patient is over-treated with unnecessary chemotherapy. Clinicians all over the world are seeking guidance from prognostic tests to determine the most appropriate course of treatment for each patient. Prognostic tests assess the risk of cancer recurrence based on specific genes or biomarkers. While most of the prognostic tests have been developed on western patient populations (from the US and Europe) and have not been validated on Indian patients, CanAssist Breast is the only prognostic test that has been developed and validated on Indian breast cancer patients.

CanAssist Breast uses a proteomics-based method and an Artificial intelligence-based algorithm to analyse a combination of 5 critical protein biomarkers along with 3 clinical parameters (tumour size, tumour grade, and node status) from the patient's tumour to compute the risk of recurrence of cancer. It gives the clinician an insight into the tumour biology of each patient. The test classifies the patient into "Low-risk" and "High-risk" of cancer recurrence by providing a risk score associated with the patient's chance of relapse. If the score is less than 15.5, a patient is considered low risk and they can safely avoid chemotherapy as the patients under the low-risk category need not be treated with chemotherapy and thus can be saved from aggressive overtreatment and its harmful side effects such as anaemia, kidney failure, skin allergies, fatigue, etc. However, if the score is above 15.5, chemotherapy is usually the recommended course of treatment.

Many oncologists across the country have started seeking the help of a prognostic test to plan the treatment regime for the patients to save the patients from the aggressiveness of chemotherapy.

In the last few years, there have been many new breakthroughs in cancer treatment that have tremendously impacted patients and their families. Disease-free survival was once considered the endpoint of treatment. However, over the last decade, the quality of life of cancer patients has become much more important. Therefore, it's no longer just about treating the disease, it's also about ensuring the quality of life of the cancer patients.

The article is contributed by Dr Deepak Jha, Sr. Consultant and Clinical Lead- Breast Surgery at Artemis Hospital.

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