As we all know, there are no specific reasons for the occurrence of breast cancer. Since, the past few years, oncologists and scientists are categorising cancer as a lifestyle disease like diabetes. While there are many known factors that cause cancer, the majority of patients diagnosed with cancer do not have any specific risk factor. A few known risk factors that can be associated with an increased risk of cancer are age, unhealthy habits, family history, etc… Cancer can occur to any gender at any age, not depending on ethnicity either.
In women, breast cancer has a higher occurrence and is a major cause of high mortality. One positive aspect about the response of breast cancer to treatment is, that it can be cured if detected early. With timely diagnosis, right treatment, and healthy living, early-stage breast cancer patients can live a normal and longer life post-cancer.
However, post-treatment, one needs to be aware of the risk of recurrence. Many patients have relapses post-surgery and present with either local or metastatic recurrence. This could happen due to various reasons. Post breast cancer surgery, patients undergo a series of treatment protocols varying from chemotherapy, radiation, hormone therapy, etc… Though these treatments are aimed to kill the cancer cells present in the body completely, there are chances that a few malignant cells escape and stay in the body unaffected. These cancer cells may be dormant for years without causing harm but these cells can also get activated after a certain period and grow and spread to other parts of the body.
Hence the question to be asked here is, “Is there a way to find out the risk of breast cancer recurrence?”
The answer is, yes! For early-stage hormone positive breast cancer, prognostic tests can help predict the risk of recurrence and help in personalising the treatment thereby, avoiding over treatment. With the help of prognostic tests, many early-stage breast cancer patients can avoid chemotherapy.
Which are these tests? Is there a test that is validated on Indian patients?
Yes! CanAssist Breast is a prognostic test developed by OncoStem Diagnostics in India and is validated on Indian patients, unlike the western prognostic tests which are not validated on Indian patients.
How does CanAssist Breast prognostic test help in identifying probable recurrence and for how many years?
CanAssist Breast uses a proteomics – based method and a proprietary machine learning-based algorithm to analyze a patented combination of protein biomarkers from the patient’s tumor to compute the risk of recurrence of cancer. Based on a recent study, CanAssit Breast can also be used to predict 10 years’ risk of recurrence.
Read more about the test here: About CanAssist Breast Prognostic Test
The FFPE block containing the tumor tissue removed from the breast during the surgery is sent to OncoStem lab along with the Histopathology reports of the patient. Upon clearing all the requisite criteria (check the criteria here), CanAssit Breast test is performed on tumor tissue. The test takes 8-10 working days (the fastest test in this category) to derive a report which highlights if the patient is at low-risk or high-risk for recurrence of cancer. If the risk prediction score is below or equivalent to 15.5, then the patient can skip chemotherapy. If the risk prediction score is above 15.5, then the patient can benefit from chemotherapy.
Recurrence risk prediction is crucial post-surgery and can be very helpful for the patient as well as the treating clinician to plan the appropriate treatment based on individual patient’s tumor biology.
More about breast cancer recurrence:
The following factors increase the likelihood of breast cancer patients developing a recurrence:
- Involvement of lymph nodes. Lymph nodes located nearby when you were originally diagnosed with cancer increase the risk of recurrence.
- Tumor size is larger. The risk of recurrent breast cancer is higher in people with larger tumors.
- Lack of radiation treatment following a lumpectomy. Most patients undergo radiation therapy post lumpectomy (removal of tumor form breast). The chance of recurrence is high in patients who skip radiation therapy or delay the treatment.
- Younger age. If the age is below 35 at the time of diagnosis, the chance of recurrence is high for breast cancer.
- Inflammatory breast cancer. Inflammatory breast cancer is a type of breast cancer where the risk of recurrence is high.
- Cancer cells with certain characteristics. Patients with Triple negative breast cancer tends to have recurrence.
- People with higher body mass index (BMI) have higher chances of recurrence.
Here are a few steps involved to prevent breast cancer recurrence:
- Post-surgery treatment. Post-surgery patients may have to undergo various therapies like hormone therapy, targeted therapy, chemotherapy, radiation therapy. Timely treatment can prevent breast cancer recurrence.
- Maintaining a healthy weight. As obesity is a key risk factor for recurrence, maintaining a healthy weight can prevent recurrence.
- Physically active. Being physically active post treatment can also benefit at large to prevent recurrence.
- Healthy diet. Including lots of vegetables, fruits and whole grains in the diet and limiting intake of alcohol can also help in preventing recurrence.
I Had Cancer, But Cancer NEVER had ME
I am Amoga. I still remember it was 2016 when I the lump was identified as cancerous growth, without any further delay I consulted the doctor. I underwent the screening & the report came as the CANCER. Yes, it was hard to digest but time was of essence.
Blurry Dreams & a Tint of Hope
A lot of thoughts clogged my mind regarding the dreaded chemotherapy. What is Chemotherapy??? Is it a really painful ??? Do I lose my hair??? In my early 40’s will I be able to take Chemotherapy??
With all these thoughts I consulted my doctor and the best thing was he suggested us to go for “CanAssist Breast” (CAB) test before opting for chemotherapy. That’s when a tint of hope entered my mind. Our doctor explained in detail about the CAB test & the risk factors. Without thinking further, we sent our FFPE blocks and reports to Bangalore Lab. We received the CAB report within 10 working days and consulted the doctor again with the CAB test report.
Leading a New Life – The wish for healing has always been half of health
CAB report mentioned that my cancer was not very aggressive and I may not benefit from taking chemotherapy. Reading the report, my doctor suggested me not to go for Chemotherapy & recommended to start with Hormone Therapy. I was relaxed hearing this & opted for Hormone therapy with regular follow-ups.
I have come through this journey strongly thinking when the sun goes down, the stars come out. It’s been 5years now being cancer-free without Chemotherapy. I would highly recommend other breast cancer patients to discuss with their clinicians and go for the CAB test.
There is a CAN in CANCER. B’coz we can beat it.
If I look back 5 years journey as a cancer survivor in my 40s, I think I am very thankful that my clinician talked to me about prognostic tests like CanAssist Breast. I was able to fight cancer without chemotherapy, thanks to CanAssist Breast test gave me a HOPE & HOPE is to live with courage & Confidence, Not Fear.
What comes to your mind when you think about breast cancer? It would most probably be ‘chemotherapy,’ ‘fear of a long process of treatment,’ ‘high costs,’ the fear of cancer coming back, and so on. These thoughts can be controlled with the right knowledge and right breast cancer treatments.
Researchers and oncologists have made new and promising forms of treatment for breast cancer. It’s time to personalize your treatment!
Our test classiﬁes patients as ‘low-risk’ or ‘high-risk’ based on the patient’s breast cancer recurrence risks over five years. The clear-cut test result provides doctors with additional information that can be used for treatment planning.
Plan the ideal treatment
CanAssist Breast is a test that helps to plan the ideal treatment by predicting the breast cancer recurrence risk within five years of surgery. The risk of recurrence is lesser in early-stage breast cancer (Stage 1 and Stage 2), and hence, it is important for doctors and the patients to plan out a suitable course of treatment based on the breast cancer recurrence risk score.
Until a few years back, oncologists and clinicians were deciding cancer treatments based on age, tumor size, node status, grade, ER, PR and HER2 status. OncoStem, with the invention of CanAssist Breast aims to fill the gap in understanding the tumor biology to comprehend the progression and its aggressiveness. CanAssist Breast helps personalise treatment depending on an individual’s tumor biology. With the benefit of validation on Indian breast cancer patients, CanAssist Breast helps in predicting the risk of recurrence accurately.
Tests similar to CanAssist Breast have been based on genomic analysis, whereas CanAssist Breast involves proteomics analysis. The genomics method considers genes of interest in the genome of a cell, whereas CanAssist Breast’s proteomics technique studies the proteins of interest produced by the cell. A 5-year study by OncoStem Diagnostics, recently published online, explains the detailed analysis and results that lead to the test, CanAssist Breast.
Your tumor is different, just like you are, as an individual.
Doctors and oncologists have to know as much possible about your tumor for optimal and ideal treatment.
A way forward – scientific, machine-learning precision
Artificial intelligence and machine learning is an emerging approach in the healthcare sector including the treatment of breast cancer. CanAssist Breast is the first such test developed in India, specifically for Indian patients. It determines the tumor’s biochemical fingerprint and assesses its aggressiveness. Assessing the tumor biology in detail, the test considers five key biomarkers that are involved in recurrence-related pathways in the cell. Based on this combined analysis performed by proteomics-based technology, the information is then assessed by a statistical algorithm that provides a score between 0 and 100 – whether the patient is at low-risk or high-risk for cancer recurrence. A ‘CAB risk score’ less than 15.5 indicates a low-risk. Depending on each patient’s unique CAB risk score, the doctors can thus plan an ideal treatment tailored to an individual’s patient.
A decision that doctors and patients must make:
‘Fear’ is the most shared and challenging emotion that cancer brings with it. However, fearful a patient might be; it is essential for the patients to know and consider that their treatment can be different from that of the other patients.
Knowing who is eligible for the CanAssist-Breast test can help both patients and doctors.
The patients must meet the below criteria to take CanAssist Breast:
- Patients with early-stage, invasive breast cancer
- Patients with hormone receptor-positive (“ER+ and/or PR+”) and HER2- negative disease
- Lymph node-negative or up to 3 lymph node-positive
- Patients should not have gone through neo-adjuvant chemotherapy
In India alone, 180,000 women are diagnosed with breast cancer every year. Of these, around 60 percent fall in the early-stage breast cancer category and a majority of them are eligible for this test.
Take your decision together
If you or someone among your friends or family are going through breast cancer (early-stage), you must consider taking CanAssist Breast before starting the treatment. If you are an oncologist or a doctor, maybe your patients could avoid the unnecessary treatments and the side effects most usually associated with chemotherapy.
Doctors must suggest the test to their eligible patients and patients must ask their doctors about the test score and personalize their treatment accordingly.
Want to know more about CanAssist Breast? Get in touch with us.
Are you amongst the millions who associate breast cancer with fatality; a disease that is almost impossible to cure and one that definitely involves chemotherapy? Most people believe that cancer treatments and medicines have little benefit. However, a look into new findings and discoveries in the field of oncology is enough to change this common perception about breast cancer.
For years, doctors and oncologists have chosen chemotherapy and radiation as a post-surgical breast cancer treatment. The knowledge, willingness, and proactive approach of the oncologists’ and their involvement with the patient’s treatment play a vital role in breast cancer treatment.
The oncologist and the patient
The oncologist is not only responsible for the diagnosis but is also responsible for providing clarity and knowledge to the patient about their cancer. Most importantly, the oncologist is responsible for deciding and charting out the best treatment course for the patient. Discussions surrounding prognosis often require oncologists to be sensitive, honest, and encouraging.
The treatment to a particular breast cancer patient and the response to treatment is unique to each patient, and the oncologist must share relevant information with the patient. Apart from this, the oncologists are responsible for post-treatment follow-up to assess the effectiveness of the treatment.
Oncologists have to consider many factors when determining a patient’s treatment and one thing that is often difficult to decide is whether a patient should be given chemotherapy or not. Several factors are considered:
- The size of the breast cancer tumor
- The stage of breast cancer
- Whether cancer is only in the breast or has spread to other parts of the body
- The hormone-receptor status of the cancer
- Whether the cancer is triple-negative (estrogen receptor-negative, progesterone receptor-negative, and HER2-negative)
- The rate of cell growth
- If the cancer is likely to come back (recurrence)
- Factors such as the age, menopausal status, and general health of the patient.
According to an assessment by WHO, cancer cases in India will multiply over five times by 2025.
Most patients associate cancer with chemotherapy and one of their first set of questions include queries about chemotherapy: How many sessions of chemotherapy will be required, what are the side-effects, what are the costs involved, will chemotherapy benefit, and what exactly happens during chemotherapy? Among other common questions are: will cancer come back after the surgery? How aggressive is cancer and how fast is it spreading?
A large number of patients and their families aren’t aware of the alternative treatments for breast cancer that are available in the country today. Hence, it is the oncologist’s responsibility to introduce the patients to new treatment options so that the patients consider all the available options.
Oncologists and cancer clinics have to be updated with the latest research and findings in the field of medical research to be able to provide the best treatment to their patients.
Breast cancer trends and cure
In India, breast cancer cases are on the rise. There has been an increase in the number of discoveries, alternative cancer care options, and innovative personalized treatment options for breast cancer patients in India.
In the last five decades, breast cancer treatment has become the model for the development and success of tailored medical treatment.
Therapeutic approaches for breast cancer have changed over the past few decades, and the use of systemic therapy for early and advanced disease tailored to the individual patient holds the promise of delivering treatment to those in need and who could benefit the most. While we’re nowhere near where we should be or could be—in either preventing or treating cancer—science has led to evident progress in treating breast cancers of different kinds.
Advances in hormone therapy for hormone receptor-positive cancer
Some breast cancers are driven by natural hormones, estrogen and progesterone. These are referred to as hormone receptor-positive if they are estrogen receptor-positive (ER positive) and/or progesterone receptor-positive (PR positive). Hormone therapy for breast cancer is only used to treat cancers that are ER or PR positive.
Despite conventional hormone therapy, approximately 20–30% of patients with hormone receptor-positive breast cancer suffer recurrences and the development of metastatic disease as they experience a biochemical mechanism of resistance. Considerable progress has been made in this area, and newer therapeutic targets have been developed against a number of hormonal resistance mechanisms.
Are all patients with early breast cancer benefiting from chemotherapy? A number of experts and oncologists asked this question. Some delved deeper into it. With this question in mind, global investigators motivated by the development of new prognostic and predictive tests such as OncoStem’s CanAssist Breast. The test focuses on personalizing breast cancer treatment to avoid over treatment and under treatment.
Clinical research is currently evaluating new therapeutic approaches and is identifying specific biological subsets that could determine a patient’s ability to respond to a particular treatment.
Scientific, machine-learning precision – CanAssist Breast
Artificial intelligence and machine learning is an emerging approach to breast cancer. CanAssist Breast is the first such test developed in India, specifically for Indian patients. It determines the tumor’s fingerprint and assesses its aggressiveness. Assessing the tumor biology in detail, the test considers key biomarkers. Based on this combined analysis performed by proteomics based technology, the information is then assessed by a statistical algorithm that provides a score – whether the patient is at low or high risk for breast cancer recurrence.
The importance of medical research
The advent of new drugs targeting specific actionable targets has led to considerable progress in the treatment of breast cancer over the past few years. Yet, some challenges such as resistance to systemic therapy, the high cost of treatments, and limited availability in many parts of the country still remain.
Experts continue to find ways to improve the available technology to provide proper guidance for those living with breast cancer and for those at high risk of developing it.
The author of this blog, Dr.Jayanti Thumsi, has been a practicing breast oncologist for 16 years, has performed 3500 breast surgeries, and 2500 other surgeries. She is an expert in Breast conservation and Breast Reconstruction surgeries. With a keen interest in spreading breast cancer awareness among women, she has conducted 258 awareness programs and has educated 158000 women. She is also the founder trustee of the CREST Foundation working to decrease the burden of breast cancer. Her book, Lump to Laughter, highlights the emotional journey of women going through breast cancer treatment.