Chemotherapy is an adjuvant treatment modalty aimed to reduce the overall risk of cancer recurrence. The benefit and need for chemotherapy can vary from patient to patient depending on the stage of cancer, cancer biology, patient baseline health status and relative age of the patient.
Stage 3 breast cancers will generally benefit from chemotherapy and omitting it may lead to a high chance of recurrence.
Depending on tumour biology and one of which is what we call the receptor status of the tumour ,will dictate if the patient is suitable for endocrine treatment (tablets).
In early breast cancers (Stage 1&2), endocrine therapy alone without chemotherapy can suffice provided the tumour biology is favourable, this needs to be dicussed with the patient's oncologist to assess the risk profile.
In the last decade, a new tool was developed to give an objective assessment if chemotherapy is necessary in a sub-group of patients with early breast cancers.This tool is known as the Oncotype Dx which asseses 21 gene profile from the individual's cancer that has been removed.
I would like to highlight some misconceptions that if one does mastectomy as oppossed to lumpectomy, then chemotherapy is not required.
The type of surgery chosen does not determine the need for chemotherapy as these are independent treatment arms to ensure a comprehensive treatment strategy for each individual which is usually tailored after discussions with both the surgeon and the medical oncologist.
