A new international study published by The Guardian on May 29 describes a significant breakthrough in breast cancer treatment — the use of a genomic test that allows doctors to precisely determine which patients need chemotherapy and which can safely avoid it.
The study is based on a large international clinical trial called the Optima trial, which included more than 4,400 patients from the United Kingdom, Australia, Norway, Sweden, New Zealand, and Thailand. The aim of the study was to determine whether genetic analysis (particularly the Prosigna test) can predict the risk of cancer recurrence and thus help guide treatment decisions.
The test analyzes the activity of approximately 50 genes in tumor tissue and classifies patients into low- and high-risk groups. Patients with low risk received only hormone therapy without chemotherapy, while the high-risk group received standard combination treatment including chemotherapy.
The results showed that among patients who did not receive chemotherapy, around 93–94% remained cancer-free after five years, which is nearly identical to the group that also received chemotherapy (approximately 95%). This minimal difference suggests that chemotherapy often provides no additional benefit for low-risk patients.
According to doctors, this approach could significantly change the standards of breast cancer treatment. The side effects of chemotherapy — hair loss, severe fatigue, nausea, risk of infertility, and neurocognitive changes — place a heavy physical and psychological burden on many patients. The new test makes it possible to deliver more personalized and less aggressive treatment.
Researchers emphasize that this represents an important step toward personalized medicine, where treatment is no longer “one size fits all” but is tailored to each patient’s genetic profile. They believe that in the future, this could spare thousands of women worldwide from unnecessary chemotherapy and improve quality of life during treatment.
In the same study, scientists note that the widespread introduction of genomic tests in clinical practice could also be economically beneficial for healthcare systems. Chemotherapy is one of the most expensive and resource-intensive treatments, so identifying patients who truly need it would significantly reduce unnecessary costs and speed up treatment for those requiring more intensive therapy.
Despite the optimistic results, specialists stress that the use of the test must be strictly controlled and integrated into the overall treatment plan. Every patient is individual, and genetic risk assessment must always be considered alongside other clinical factors such as age, cancer stage, and overall health condition. According to researchers, maintaining this balance will be crucial for the safe and effective implementation of this technology in practice.
