New test may reduce chemotherapy use in breast cancer

A new test called IHC4 that is being considered for use on the NHS could identify patients at such low risk of their breast cancer returning after surgery that they may be spared chemotherapy, according to research published in the British Journal of Cancer reports Breakthrough Breast Cancer.

The study of 101 patients – conducted by scientists in the Breakthrough Breast Cancer Research Centre at The Institute of Cancer Research (ICR) and clinicians at The Royal Marsden Hospital – suggested that almost half of patients currently classified as at intermediate risk of recurrence would be downgraded to low risk by the test. This would mean they would potentially safely avoid chemotherapy and its toxic side effects.

The IHC4 test uses simple technology that is available in most treatment centres around the UK and is relevant to the treatment for patients with oestrogen receptor  positive (ER positive) breast cancer. This is the most common type of the disease, accounting for around three out of four breast cancer cases, totalling around 36,000 patients in the UK each year. While many of these patients will benefit from chemotherapy, others have very low risk disease and this molecular test will help identify this group.

Professor Mitch Dowsett, from the Breakthrough Breast Cancer Research Centre at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, said: “This is a simple, cost-effective test. This new research suggests many additional patients could be classified as at low risk, and therefore avoid chemotherapy and its toxic side effects. This could make a big difference to those patients, and also save the NHS money. It is currently being assessed by NICE for widespread use through the NHS.”

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