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American Morning
Genetic Test for Breast Cancer Prognosis
Aired December 19, 2002 - 08:49 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, CNN ANCHOR: There is a new genetic test for breast cancer that can make a big difference in the way the disease is treated. Let's turn to Sanjay Gupta, who is standing by in Atlanta with details -- good morning, Sanjay.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Paula. Well, you and I have talked about breast cancer a lot, and this is another piece of evidence about the way that breast cancer is diagnosed, and the way that the prognosis is determined.
We are talking about a genetic or molecular signature. Paula, let's just, first of all, take a look at some of the ways a woman with breast cancer may get an idea of what her prognosis might be. There are all sorts of different factors.
You can see them right there. Age, tumor size, lymph nodes, type of tumor, all those sorts of things will actually give doctors and the patient, more importantly, a sense of how the tumor is going to behave, how it will behave over time.
And that is obviously based a bit on actually looking at the tumor after a particular operation. What study researchers decided to do in Amsterdam was actually look at almost 300 women, all under age 53, incidentally, with low-grade breast cancer.
And what they did was actually stratify them into women who had what they call a good prognosis group in terms of their genetic profile, and a bad prognosis group.
And let's take a look at some of the numbers of what they found.
If they had a good prognosis group, meaning they fell into a good genetic profile, at ten years, they had a 94.5 percent survival. Poor prognosis group women had a 54.6 percent survival. Dramatic difference.
Paula, what is even more startling about this and something that you and I have talked about is that even in women who had positive lymph nodes, which is currently one of the best predictors of how a woman with breast cancer might do, if they positive lymph nodes and a good prognosis genetic profile, they were more likely to still do well, despite those positive lymph nodes.
So not only is this actually a very good test in terms of determining prognosis, it's actually countering some of the best -- best existing tests there are right now. I'll tell you right now, Paula, it was a small group of women, relatively. They were all under the age of 53. Very early sort of clinical trial, but very promising -- Paula.
ZAHN: This also could lead to break-throughs too in determining who needs chemotherapy and who doesn't after surgery, right?
GUPTA: That's right. Doctors have been really frustrated by the fact that they have a pretty good sense of who is going to develop metastasis, that is spread of the disease. Women that aren't going to do well from their breast cancer, and they obviously give them what is known as adjudent (ph) therapy, chemotherapy, radiation, hormone-based therapy.
But a lot of times, the tumors just haven't been behaving quite the way doctors would have predicted.
So this certainly will give doctors a much sort of more pinpoint assessment of whether or not someone should actually get chemotherapy or radiation therapy.
ZAHN: And are these genetic tests widely available?
GUPTA: Well, there is the thing. They are not widely available yet. Certainly, you can do genetic testing on tumors right now, but as far as basically being absolutely sure as what to do with the information, that is still information they need to gather.
A couple of caveats to this particular study, for example. they didn't look at women over the age of 53. We need to do that, studiers need to do that in order to be able to tell, does a tumor behave differently in older women. And they also need to look at more advanced cancers.
Paula, this has the potential to possibly change the way we grade tumors. You have talked to a lot of patients with breast cancer. They will tell you, I have a grade one tumor, or a grade two tumor. This genetic profiling may just change the way we talk about this, say I have a good prognosis genetic tumor or bad prognosis genetic tumor.
That all still needs to be worked out, so probably down the line, but I think it is really promising -- Paula.
ZAHN: Yes, it is kind of hard to be patient, though, when you are hoping to get this information to so many women who have gotten this diagnosis so far this year.
GUPTA: Yes, that's right. Making some good steps, though.
ZAHN: All right. Sanjay Gupta, thanks for helping us better understand this very complicated story this morning.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired December 19, 2002 - 08:49 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, CNN ANCHOR: There is a new genetic test for breast cancer that can make a big difference in the way the disease is treated. Let's turn to Sanjay Gupta, who is standing by in Atlanta with details -- good morning, Sanjay.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Paula. Well, you and I have talked about breast cancer a lot, and this is another piece of evidence about the way that breast cancer is diagnosed, and the way that the prognosis is determined.
We are talking about a genetic or molecular signature. Paula, let's just, first of all, take a look at some of the ways a woman with breast cancer may get an idea of what her prognosis might be. There are all sorts of different factors.
You can see them right there. Age, tumor size, lymph nodes, type of tumor, all those sorts of things will actually give doctors and the patient, more importantly, a sense of how the tumor is going to behave, how it will behave over time.
And that is obviously based a bit on actually looking at the tumor after a particular operation. What study researchers decided to do in Amsterdam was actually look at almost 300 women, all under age 53, incidentally, with low-grade breast cancer.
And what they did was actually stratify them into women who had what they call a good prognosis group in terms of their genetic profile, and a bad prognosis group.
And let's take a look at some of the numbers of what they found.
If they had a good prognosis group, meaning they fell into a good genetic profile, at ten years, they had a 94.5 percent survival. Poor prognosis group women had a 54.6 percent survival. Dramatic difference.
Paula, what is even more startling about this and something that you and I have talked about is that even in women who had positive lymph nodes, which is currently one of the best predictors of how a woman with breast cancer might do, if they positive lymph nodes and a good prognosis genetic profile, they were more likely to still do well, despite those positive lymph nodes.
So not only is this actually a very good test in terms of determining prognosis, it's actually countering some of the best -- best existing tests there are right now. I'll tell you right now, Paula, it was a small group of women, relatively. They were all under the age of 53. Very early sort of clinical trial, but very promising -- Paula.
ZAHN: This also could lead to break-throughs too in determining who needs chemotherapy and who doesn't after surgery, right?
GUPTA: That's right. Doctors have been really frustrated by the fact that they have a pretty good sense of who is going to develop metastasis, that is spread of the disease. Women that aren't going to do well from their breast cancer, and they obviously give them what is known as adjudent (ph) therapy, chemotherapy, radiation, hormone-based therapy.
But a lot of times, the tumors just haven't been behaving quite the way doctors would have predicted.
So this certainly will give doctors a much sort of more pinpoint assessment of whether or not someone should actually get chemotherapy or radiation therapy.
ZAHN: And are these genetic tests widely available?
GUPTA: Well, there is the thing. They are not widely available yet. Certainly, you can do genetic testing on tumors right now, but as far as basically being absolutely sure as what to do with the information, that is still information they need to gather.
A couple of caveats to this particular study, for example. they didn't look at women over the age of 53. We need to do that, studiers need to do that in order to be able to tell, does a tumor behave differently in older women. And they also need to look at more advanced cancers.
Paula, this has the potential to possibly change the way we grade tumors. You have talked to a lot of patients with breast cancer. They will tell you, I have a grade one tumor, or a grade two tumor. This genetic profiling may just change the way we talk about this, say I have a good prognosis genetic tumor or bad prognosis genetic tumor.
That all still needs to be worked out, so probably down the line, but I think it is really promising -- Paula.
ZAHN: Yes, it is kind of hard to be patient, though, when you are hoping to get this information to so many women who have gotten this diagnosis so far this year.
GUPTA: Yes, that's right. Making some good steps, though.
ZAHN: All right. Sanjay Gupta, thanks for helping us better understand this very complicated story this morning.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
