Genetic Test for Breast Cancer Could Save NHS Millions, Spare Women Chemotherapy

The National Health Service (NHS) could realize significant savings and spare thousands of women from the harsh side effects of chemotherapy by expanding the use of a genetic test for low-risk breast cancer. Experts suggest that making the Prosigna test more accessible could save the NHS approximately £4 million per year and prevent over 4,000 women annually from experiencing debilitating chemotherapy side effects.

The Prosigna test analyzes the activity of 50 genes in a tumor sample to assess the risk of breast cancer recurrence. Currently, its use is restricted to post-menopausal women whose cancer has not spread to more than three lymph nodes. However, researchers at University College London (UCL) propose extending its application to women as young as 40.

Presenting findings at the European Society of Medical Oncology meeting in Madrid, Dr. Rob Stein stated that Prosigna testing allows about two-thirds of patients with specific types of breast cancer to safely avoid chemotherapy. He added that this not only benefits patients but also reduces healthcare costs.

Breast cancer is the most common cancer globally among women, with approximately 60,000 new invasive cases diagnosed annually in the UK alone. Around 80% of these are estrogen-receptor positive cancers, which are typically treated with hormone-blocking drugs. Chemotherapy is often recommended for patients whose cancer has spread to nearby lymph nodes to reduce the risk of recurrence. However, concerns are growing that many women with this cancer type experience little benefit from chemotherapy while still suffering its side effects, which can include nausea, vomiting, hair loss, and increased infection risk.

Results from the OPTIMA trial, which involved 4,429 women aged 40 and over with cancer that had spread to up to nine lymph nodes or had tumors measuring 30mm or more, indicated that 67% of patients tested did not require chemotherapy. This equates to an estimated 4,200 patients per year.

Analysis indicates that chemotherapy costs the NHS around £5,500 per patient within the first two years after diagnosis, encompassing drug costs, nursing care, hospital stays, and management of side effects. The Prosigna test, costing approximately £1,955 per patient in the UK, reduced these costs by an estimated £3,611 per patient, according to Professor Peter Hall from the University of Edinburgh.

Considering additional factors, such as potentially earlier initiation of other treatments for those who forgo chemotherapy, Prof. Hall calculated that offering the Prosigna test could lead to a saving of about £654 per patient within the first two years post-diagnosis. Extrapolated across all eligible women annually, the NHS could save approximately £4 million.