Patient Success Stories

New test helps determine proper cancer treatments

Fall 2006 — Some early-stage breast cancer patients can avoid chemotherapy.

One of the most troubling aspects of breast cancer for 44-year-old Monica Evans of Matteson wasn't the double mastectomy she was facing. What really bothered her was how she was going to handle the demands of her busy family and career as a high school teacher, while contending with chemotherapy. "I was very concerned about how I would be able to meet the demands of my job and my family," says Evans, who is also a minister.

But thanks to the results of a state-of-the-art, individualized test available to women with hormone-sensitive, early-stage breast cancer at Ingalls, Evans was able to avoid chemotherapy.

"I was prepared for chemotherapy, but the test results showed that there was a 92-percent chance that the cancer would not return even without chemotherapy," she said. "As a teacher, a score of 92 percent is pretty good, so that's the way I decided to go".

According to pathologist Enric Solans, M.D., the test that Evans is referring to is the Oncotype DX Breast Cancer Assay, a gene expression test that is done on the tumor specimen itself. This test, available at Ingalls, can help predict the likelihood of cancer recurrence and if chemotherapy would be beneficial in treating the cancer. It is intended for women whose cancer has not spread to lymph nodes and who have tumors that are sensitive to hormone therapy.

Approximately half of the 230,000 patients diagnosed with breast cancer in the United States each year fall into this category, explains Elaine Lee Wade, M.D., board-certified hematologist/oncologist and medical director of Women's Oncology Services at Ingalls.

"While patients with early breast cancer can derive a significant survival benefit with chemotherapy, others can do well with surgery and hormone therapy alone."

Developed by Genomic Health and based on the clinical study of thousands of breast cancer patients, Oncotype DX is a simple test that uses a small amount of breast tumor tissue removed during a standard lumpectomy, mastectomy or biopsy.

What makes the test at Ingalls unique is that it is automatically used on all breast tumor tissue samples from women who have early-stage, lymph node-negative, estrogenreceptor positive breast cancer. "That puts Ingalls on par with large, academic medical centers," Dr. Wade adds.

For 56-year-old Paulette Bannack of Roselle, the results of the Oncotype test confirmed that chemotherapy, coupled with radiation and hormone therapy, would be the best course of treatment.

Bannack, who was facing her second bout of breast cancer in nine years, had undergone a lumpectomy, chemotherapy and radiation for early-stage cancer of her left breast in 1997. She was diagnosed with early-stage cancer of the right breast in 2005, although the second cancer was not related to her earlier bout with breast cancer.

"The test results showed that without chemotherapy, there was a very good chance the cancer would return," she says. "It was very clear to me what I needed to do."

Bannack was also thrilled with the care that she received. "Dr. Wade is fantastic, and I would recommend her to anyone," she said.

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