Early stage breast cancer (up to 5cm in size, 0-3 lymph nodes involved) that is estrogen/progesterone receptor positive and HER2 negative is usually treated first by surgery.

Once surgery is complete, the care team must decide whether or not a woman should be given chemotherapy. Traditionally, if a woman’s cancer was larger than 1cm in size or if she had even one node positive for disease, she was advised to receive chemotherapy.

Chemotherapy for breast cancer has been shown to increase the time that a woman lives cancer-free and to increase her overall length of life. However, it has its drawbacks. Short-term, side effects include hair loss, weakness, decreased blood cell count and fatigue. These problems can severely limit a woman’s ability to carry out her daily responsibilities and affect her sense of well-being. Long-term, chemotherapy may cause permanent damage, such as cognitive impairment and nerve pain.

Breast cancer physicians and scientists began asking if every woman who was offered chemotherapy actually needed it. Years of research produced the Oncotype Recurrence Score. This test is commonly done after surgery. The cancer cells are sent to a specialized lab where their genomic profile – a set of specific genes – is evaluated. This profile can be thought of as the cancer cell’s signature, or fingerprint. The features of the profile are translated into a numerical score, which predicts the likelihood that a woman will – or will not -benefit from chemotherapy.

The Oncotype test has revolutionized the way breast cancer is treated. It is one of the genomic profile tests that have become the standard of care in evaluating and planning treatment for breast cancer.