A major international study has highlighted how genetic testing could help doctors make more personalised treatment decisions for some women with early-stage breast cancer. The research examined the Prosigna gene-expression test, which analyses activity in tumour tissue to estimate the likelihood of cancer returning.
The findings suggest that certain patients may be able to avoid chemotherapy when their cancer has a low predicted risk of recurrence and other treatments are appropriate. The approach could help reduce unnecessary treatment side effects while allowing doctors to tailor care to an individual’s cancer characteristics.
What the International Study Found
The OPTIMA trial followed more than 4,400 women across several countries. Researchers examined whether using a gene-expression test could help doctors identify patients who might not need chemotherapy in addition to other treatments.
Approximately 68% of the women assessed with the test were classified as low risk. Among comparable patients, five-year cancer-free survival was 93.6% for those receiving hormone therapy alone, compared with 94.8% for those receiving hormone therapy and chemotherapy.
These results suggest that genetic information may help clinicians distinguish between patients who are more likely to benefit from chemotherapy and those for whom its additional benefit may be limited.
How the Prosigna Test Works
Prosigna analyses the activity of 50 genes in a breast tumour sample. It uses this information, alongside relevant clinical details, to estimate the risk of cancer returning.
The test is primarily intended for certain patients with early-stage, hormone receptor-positive and HER2-negative breast cancer. These characteristics matter because different breast cancer types can behave differently and respond to different treatments.
By combining molecular information with tumour features and a patient’s overall medical circumstances, doctors can make more informed decisions about treatment options.
Avoiding Chemotherapy Does Not Mean Avoiding Treatment
Chemotherapy can cause side effects such as fatigue, nausea and an increased risk of infection. For patients who are unlikely to gain meaningful additional benefit, avoiding it may improve quality of life.
However, a low-risk test result does not guarantee that cancer will never return. Patients may still need surgery, hormone therapy and, in many cases, radiotherapy. The appropriate treatment plan depends on the type and stage of cancer, test results and individual health factors.
The findings should not be interpreted as a reason for patients to stop or refuse prescribed treatment without consulting their oncology team.
What the Findings Mean for Breast Cancer Care
Gene-expression tests are part of a broader move towards personalised cancer treatment. Rather than recommending the same treatment for every patient, clinicians can increasingly consider biological differences between tumours.
The research could support more targeted treatment decisions and help some patients avoid chemotherapy when the expected benefit is small. However, access to testing and reimbursement arrangements vary between countries, including India.
Ultimately, the test is a decision-support tool, not a guarantee of an outcome. Patients should discuss its suitability, limitations and potential benefits with their cancer specialist before making treatment decisions.
