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Many breast cancers are treated by removing as much of the cancer as is possible, and then using one or more other therapies to kill or control any remaining cancerous cells. A lumpectomy removes the cancerous tissue while leaving the remaining breast tissue intact. A mastectomy is a more extensive procedure but can still vary in the amount of the breast removed. While mastectomy was once the preferred treatment even in early stage breast cancer, more choices have become available. Now, lumpectomy followed by radiation has been demonstrated to be as effective as a mastectomy in treating early stage breast cancer. In performing either a lumpectomy or mastectomy, a doctor may remove some or all of the lymph nodes under the arm to help assess whether the cancer has spread.

There is a great deal of new research being performed in the field of breast cancer treatment, and your doctor is your best source of information. Your surgeon or medical oncologist may talk to you about a test called the Oncotype DX Breast Cancer Assay, or Oncotype DX. This is a relatively new test in Australia, although it is widely used in the United States.

This test analyses 21 genes within the tumour tissue to assess risk of recurrence. It may be useful to determine whether or not you would benefit from chemotherapy. If the test shows you have a high risk of recurrence, chemotherapy may be recommended. If the risk of recurrence is low, you can have less-invasive treatments, such as radiotherapy and hormone therapy. Oncotype DX is not suitable for all types of breast cancer. It is useful in women with oestrogen receptor positive (ER+) tumours and patients where the cancer has not spread to the lymph nodes or have no more than three positive lymph nodes. 

If you want to get this test done, your physician will ask the pathologist (the doctor who examined the tumour tissue after removal by surgery) to provide a little bit of tumour tissue for Oncotype DX testing. This tissue will be sent to America, where all Oncotype DX testing is presently being performed. Your doctor will receive the results most likely within 2-3 weeks.

At the moment, there is no Medicare rebate for the Oncotype DX test. The test costs around $4,000. You may ask to get a rebate from your private health insurance, if you have any. 

New drugs, called aromatase inhibitors, can stop the production of oestrogen in postmenopausal women with hormone-sensitive cancers. Other drugs, some with fewer side effects than older drugs, are being developed for treatment. In addition, there are promising gene-targeting drugs and vaccines, some of which are already being used on a limited or trial basis.

Breast cancer tissue banks
Tissue banks also collect breast cancer samples, and information about the women who donate them, for use in breast cancer research. If you agree to participate, you will be asked to complete consent forms. You might be asked for consent before your surgery by a letter or in person. A small amount of your breast cancer tissue will be given to the tissue bank. This will not jeopardize the amount of tissue required by the pathologist for your pathology reporting.

Last Review Date: October 26, 2014