A quarter of women with aggressive breast cancer could do without chemotherapy

A quarter of women with an aggressive form of breast cancer (triple negative) have an immune system strong enough to fight the tumor. Thus, according to a study conducted by Dr. Roberto Salgado, an employee of the Antwerp ZAS Hospital, chemotherapy will be unnecessary.

Dr. Salgado’s research, published in the medical journal Journal of the American Medical Association, looked at triple-negative breast cancer, an often more aggressive form characterized by the absence of estrogen receptors, progesterone receptors and the HER2 protein. The research team collected data from nearly 2,000 women around the world and followed them for an average of 18 years.

It appears that “if their immune system has sufficient numbers of anti-cancer cells, women with triple-negative breast cancer detected at an early stage have a high chance of survival and a low risk of recurrence even without chemotherapy,” the study concludes. This will affect 25% of patients suffering from this type of tumor.

About one in seven women with breast cancer has triple negative breast cancer. This type of cancer does not respond to hormonal treatments, making it difficult to treat. Therefore, most patients with this type of tumor are referred early to chemotherapy, which often causes serious side effects.

Currently, the number of immune cells is not taken into account when deciding whether chemotherapy is needed. Instead, doctors rely on the size of the tumor and whether the cancer has spread to the lymph nodes.

A test that checks a woman’s tumor-infiltrating lymphocytes (TILs) can determine whether she needs chemotherapy.

“The results (of the study, editor’s note) may serve as a recommendation to consider TILs in breast cancer pathology reports,” said Dr. Salgado. “A simple examination can better inform doctors and their patients about treatment options. It does not require expensive tests.”

The team will now begin testing how TILs can be used as a cornerstone in determining the need for chemotherapy.