There was a time when breast cancer treatment was based mostly on tumor size: the bigger the tumor, the more aggressive the treatment.
But the OncoType DX test is rewriting the rulebook.
OncoType uses the tumor's genetics to measure how aggressive it is.
"It tells the risk of it recurring at 10 years," said Dr. Abu-Khalaf. "It also predicts the benefits from chemotherapy, whether it really needs chemo or not."
Dr. Maysa Abu-Khalaf of Jefferson's Kimmel Cancer Center says the groundbreaking Tailor-X study out in June showed that 70 percent of women with early-stage, estrogen-positive, HER-2 negative cancer don't need chemotherapy.
Abu-Khalaf said if even a larger tumor has a low OncoType score, it can be stopped with surgery and hormone blockers.
"It's more of a personalized approach to treatment," she said.
Jefferson surgeon Theodore Tsangaris said many patients want radical mastectomies - not because they need them, but because they're overwhelmed by the diagnosis and want to simplify treatment.
"We're getting all this wonderful data and it's causing a lot of anxiety," said Tsangaris.
So he and his team take more time explaining all the options, reassuring patients that more conservative surgery is usually just as effective but even mastectomies these days have seen a lot of changes.
"We can make them look better than when they walked in the door," said Tsangaris.
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