Dr. Whitworth on Treating Breast Cancer With Chemo

Pat W. Whitworth, MD, Associate Clinical Professor of Surgery, Vanderbilt University Medical Center, explains there is a strong historical connection between treating patients with chemotherapy and the risk of recurrence for patients with breast cancer.

Traditionally providing chemotherapy to high-risk patients was tied to concerns for the patient. The higher the concern the more likely the patient was to receive chemotherapy. Early on there was not an accurate way to target chemotherapy sensitive patients, which is why lymph node status was used as an indicator.

There was a paradigm shift in 2006 when the B20 chemotherapy benefit study discovered that a 21-gene assay could determine a patient’s sensitivity to chemotherapy. This helped change the way that oncologists thought about risk and chemotherapy.

Whitworth notes that it is difficult to translate a change in understanding into a change in practice, especially given the strong emotional connection between risks and chemotherapy.