New studies suggest this "less-is-more" approach can work.
Rachel Rawson, clinical nurse specialist at Breast Cancer Care, said: 'This life-changing breakthrough is absolutely wonderful news as it could liberate thousands of women from the agony of chemotherapy.
Now, a massive breast cancer study has just revealed that most women in the early stages of one of the most common forms of the disease can completely skip chemotherapy without harming their chances of survival, remission or recurrence.
But doctors have been unsure how to treat women with scores in the intermediate range of 11 and 25.
This ability of cancer to change its genes - a process called immunoediting - had never been described in colon cancer before, and the new understanding could help researchers develop new immunotherapies that target those genetic changes.
Women with scores of 10 or lower were considered not to need chemotherapy while those with scores 25 and over were considered to need it.
The study involved a phase III clinical trial involving more than 10,000 women.
The patients in this group were randomly assigned to chemotherapy with supplemental hormone therapy or just hormone therapy alone.
"Most women diagnosed with breast cancer are over 50, but younger women can also get breast cancer", says the NHS on its website.
But before this study came out, many people in this group were prescribed chemotherapy because doctors had, based on the best information available, assumed it would help them.
"Now with these genomic tests, we are finding that we have multiple types of breast cancer, perhaps several dozen", said Brawley, "and we are being able to tailor our therapies to the type of breast cancer every woman has".
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The study is the largest ever done of breast cancer treatment, and the results are expected to spare up to 70,000 patients a year in the United States and many more elsewhere the ordeal and expense of these drugs. This characterizes about half of all new breast cancer patients.
Professor Keane said the test will identify which women will benefit from endocrine (hormone) therapy only. The trial results are the latest salvo in a heated debate over when and how to use chemotherapy in combating the spread of the disease.
Breast cancer is the most common cancer among women in India.
It will spare 500 to 600 women in Ireland having chemotherapy annually.
According to the TAILORx researchers, 260,000 women who are diagnosed with breast cancer each year around the world fall into the medium-risk category that wouldn't benefit from chemotherapy.
Litton, the MD Anderson oncologist, said doctors need to consider each case on its own merits and cautioned against ruling out chemo too quickly.
"You can get them to the same place... without side effects and toxicity", he said.
During the study, the women were given a genetic test called Oncotype DX to determine their risk for cancer reoccurrence. Perkins said she "cornered her with a beer" and said she wanted to enroll.
Jacoub told Healthline it's the women with mid-range scores of between 11 and 25 that have provided oncologists with tough decisions.
Dr. Jennifer Litton at MD Anderson Cancer Center in Houston, agreed, but said: "Risk to one person is not the same thing as risk to another".
Women can have the tendency to turn towards chemo, even if the results have a relatively small benefit, Albain says. Minute amounts of these natural T-cells infiltrate the tumor, though they aren't present in high enough quantities to combat the growing cancer, Rosenberg said.
For many breast cancer patients, one of the most hard treatment decisions is whether or not to go through chemotherapy.