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Breast cancer recurrence gene test gets NHS go-ahead

9 February 2015
Appeared in BioNews 789

A genetic test to estimate the chance of breast cancer recurrence after surgery is set to become more widely available on the NHS.

From April 2015, hospitals will be able to sign up to an access program enabling them to provide the Oncotype DX Breast Cancer Assay to eligible breast cancer patients after surgery. The test aims to help decide whether or not to prescribe chemotherapy to breast cancer patients after surgery by trying to better predict the chances of distant recurrence of the cancer.

Although recommended by the National Institute for Health and Care Excellence (NICE) in 2013 for use in patients with certain types of early stage breast cancer (reported in BioNews 724), the test has not been widely used so far due to its cost of between £2,000 and £2,500 per patient, says the Daily Mail.

The access programme allows NHS hospitals to provide genetic testing to some patients by implementing the NICE diagnostic guidance, explains the company behind the test, Genomic Health. Its chief operating officer and chief financial officer, Brad Cole, said: 'In the past few years, more than 3,500 women in the UK have used the Oncotype DX test, and we believe the latest agreement will facilitate quick adoption throughout England.'

In the UK around 50,000 women are diagnosed with breast cancer each year. Once a tumour is surgically removed, a course of chemotherapy and drugs may be prescribed to minimise the chances of recurrence.

However, chemotherapy has a number of unpleasant side effects. Research has shown that fewer than ten percent of patients with early-stage breast cancer actually benefit from chemotherapy, with current methods for making treatment decisions often resulting in over-treatment. This can cause both decreased quality of life for the patient and increased costs for the NHS.

Professor Kefah Mokbel, of the London Breast Institute, told the Daily Mail that up to 25 percent of breast cancer patients will be eligible for the test. Genomic Health states that almost one third of treatment recommendations for early-stage breast cancer patients changed after the using the Oncotype DX test.

The test looks at the expression of 21 genes in breast tissue removed during surgery. It then indicates how likely recurrence will be and if the patient will benefit from chemotherapy, giving patients a score on a scale of 1-100.

This score, along with more traditional methods of assessing the chances of cancer recurrence, can help doctors to decide whether or not chemotherapy will be beneficial to the patient.

Dr Emma Pennery, clinical director from Breast Cancer Care charity, told the Daily Mail the test would be invaluable. She said, 'This test could enable [patients] to avoid the brutal side-effects of chemotherapy without compromising their survival.'

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