How personalised medicine shapes breast cancer treatment? Why women with similar diagnoses receive different therapies based on tumour biology.
Advances in breast cancer diagnosis are helping doctors to precisely investigate different breast tumor types and provide personalized treatment for patients. One may be advised to take hormone-blocking tablets and, based on further testing, may safely avoid chemotherapy.
“The other may need surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of treatments”, Dr Prashanth Bagali, Head of Scientific Affairs, Oncology and Rare Diseases, MedGenome Labs Ltd, tells Health Shots. Why do their treatment plans differ despite having seemingly similar breast cancer? Understanding these differences helps doctors select the most appropriate treatment for each patient.
Understanding the different types of breast cancer
These include estrogen receptor (ER) and progesterone receptor (PR) tests that determine whether cancer cells respond to hormonal therapy, because ER and PR stimulate tumor growth. HER2 testing checks for excess HER2 protein expression, which promotes cancer growth.
- Tumor grades and cancer stages are different. Still, HER2-targeted treatments have significantly improved outcomes. Depending on the cancer stage and individual circumstances, treatment may include HER2-targeted medicines alongside chemotherapy.
- TNBC requires hereditary cancer next-generation sequencing panels to identify inherited BRCA1, BRCA2, PIK3CA, ESR1, RAD51C, and PTEN genes and determine treatment options, such as chemotherapy, immunotherapy, PARP inhibitors, or combinations of these treatments.
How advanced testing helps refine treatment?
No single marker defines a tumour’s molecular signature. While routine pathology and receptor testing provide the foundation for treatment decisions, advanced genetic and genomic tests play an important role in prognosis, treatment selection, family counseling, determining drug efficacy, and monitoring recurrence or relapse of cancers. Depending on test results, Oncologists discuss treatment choices, surgical decisions, future cancer screening, and risk assessment tests with patients and family members. A genetic test result isn’t just information for the patient; it’s information for the entire family.
The right treatment for the right patient
Genomic testing in the early stages of cancer helps examine the activity of multiple cancer-causing genes to estimate the risk of cancer recurrence (cancer relapse) and guide treatment decisions. Beyond diagnosis, other genomic tests look for specific DNA changes that may guide targeted treatment, particularly in advanced cancer.