Breast cancer is the leading cause of cancer death in women worldwide, causing some 1.7 million new cases annually and over half a million deaths.
Instead of chemo therapy, most women with early stage breast cancer can take a hormone blocking pill with the same results, Figueredo said.
"With results of this ground-breaking study, we now can safely avoid chemotherapy in about 70% of patients who are diagnosed with the most common form of breast cancer", said co-author Kathy Albain, an oncologist at Loyola Medicine.
"Those are the cancers that have likely already metastasized and a small amount could be hiding in a woman's lung, liver or bones", said Brawley.
The TAILORxtrial used the Oncotype DX test, now available on the NHS, which allows doctors to predict the likelihood of the breast cancer returning.
The test assigned women a score from 0 to 100, based on the likelihood cancer would return within 10 years.
Very high scores are at increased risk of the cancer spreading, and those patients have benefited a lot by chemotherapy.
For many patients, it's a hard choice to decide whether to go through chemotherapy.
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Dr. Rosenberg added, "This is highly experimental and we're just learning how to do this, but potentially it is applicable to any cancer".
In past studies. doctors looked back at the data for patients in this third group and determined that they would benefit from chemotherapy.
Such patients have been in "the gray zone, and we haven't known what to tell them", Kurian said.
The Oncotype DX genetic test has been available on the NHS since 2013, but the National Institute for Health and Care Excellence (Nice) is now updating its guidance on whether it should be recommended for use.
The study used a gene test done on tumors to help decide whether a woman would benefit from chemo or if they could receive hormone therapy.
However, there is still uncertainty about the benefit of chemotherapy for most patients who have a midrange score, they specified. The most common chemotherapeutic regimens used to treat women in the dual, chemoendocrine therapy group were either a docetaxel-cyclophosphamide regimen or anthracycline-containing regimens. However, it's not certain that the technique will be equally effective for everybody who needs it - there's a good chance the success rate might be much lower.
The overall survival rate was similar: 93.9% for those who received hormone therapy alone and 93.8% for those who received both therapies.
This is the largest study ever done on breast cancer treatment.
However, among younger women with scores 16 to 25, outcomes were slightly better in the chemotherapy group, so in those cases, doctors may urge patients to consider a chemo regimen.
"Oncologists have been getting much smarter about dialing back treatment so that it doesn't do more harm than good", said Steven Katz, a University of MI researcher who examines medical decision-making.
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