Determining Risk of Recurrence in Patients With Breast Cancer Could Inform Treatment Decisions

Joseph A. Sparano, MD, professor in the Department of Medicine and Department of Obstetrics & Gynecology and Women's Health at the Albert Einstein College of Medicine, discusses how identifying the risk of recurrence in patients with breast cancer can help inform treatment decisions.

The decision for what therapy to use in a patient who is not benefiting from chemotherapy would depend on the underlying risk of recurrence as assessed by a new tool, which Sparano highlighted during a presentation during the 2020 San Antonio Breast Cancer Symposium (SABCS). For postmenopausal women who have substantial risk of recurrence, the only option is to ensure they receive the most optimal endocrine therapy, and the only option available in this setting is an aromatase inhibitor.

The standard treatment for most premenopausal women is tamoxifen (Soltamox), but premenopausal women at higher risk of recurrence could have lower risk when treated with ovarian function suppression and an aromatase inhibitor, says Sparano. If tools such as this are expanded to other higher risk clinical scenarios, physicians could identify patients who may be more likely to benefit from experimental therapies in clinical trials or novel therapies that have proven to be effective in high risk scenarios, such as CDK4/6 inhibitors.