The small number of patients in the study, the relatively short follow-up time, and the lack of information about treatment lessen the importance of news of a blood test that may predict relapse of early stage breast cancer patients.
Most of the 200,000 women diagnosed each year with breast cancer are diagnosed at an early stage but fear of a recurrence impacts their treatment decision process. A blood test that could accurately predict one’s chance of a recurrence would be valuable information for those newly diagnosed with breast cancer.
But let’s not lose sight of a bigger need: wouldn’t it be better if it could help figure out who might benefit from treatment? There are lots of ways to predict risk so this might refine or add to those.
No information is given about the projected cost of the test, despite the projection that “the test may not be far off in terms of clinical practice.”
The writer makes it clear that while lymph node status “is currently the best way to predict survival in women with breast cancer” some women with no cancer in their lymph nodes will eventually experience a relapse of their cancer.
But then the story never discussed comparing this approach with current approaches to predict risk (including Oncotype, Adjuvant online, lymph node status etc).
So what is the comparative benefit?
Quotes from experts not connected with the study give readers valuable perspective on the current usefulness of the test. Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, notes that the presence of circulating tumor cells may not be sufficient predictive information.
Justin Sebbing, a professor in the department of surgery and cancer at Imperial College in London, cautioned that it’s currently uncertain “…how this information can be integrated into present practice.”
The writer also notes that the American Society of Clinical Oncology does not recommend that clinicians measure circulating tumor cells in patients.
These three cautions should help readers understand that if accuracy is not established, use of a test to guide therapy decisions could lead people down the wrong path.
There was adequate discussion of the evidence – and the limitations of the evidence at this point.
There is no disease mongering.
Two experts not connected with the study are quoted. Both provide valuable perspective on the clinical usefulness of the blood test to current patients.
Readers are told that lymph node status is currently the best predictor of survival for women with breast cancer but there is no mention of other predictors, such as tumor size and grade, estrogen receptor status, and HER2 status, that are also used to help women make their surgery and treatment decisions.
There is no mention of existing tests such as Oncotype DX that can be used for many women with early stage breast cancer.
No information about the availability of the blood test is given. There’s only the line about “may not be far off in terms of clinical practice.” But readers might not pick up on that subtle note.
The writer notes that similar blood tests are used to test women with metastatic cancer. We wish the story had been more explicit about whether this is a totally new blood test and if other blood tests like this are also being tested.
The piece does not appear to solely rely on a press release because several quotes are included from experts not associated with the study.