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Last week the New England Journal of Medicine, the most respected journal in medicine, released an article on gene profiles of patients with breast cancer and the advisability of chemotherapy. This article has been quickly picked up by the lay press and assumptions were proposed by the press that need many patients are receiving chemotherapy that dont need it. This needs some explanation!

Clearly being able to identify patients by some means that will predict eventual outcomes is exciting. It also makes much sense that evaluation of genetic background could be these means. On the other hand, the research presented in the article is very preliminary work and not readily available to all patients yet. In addition, the implications for care, are also not clear even in the very select group discussed in the article.

A similar report came out about a year ago in regard to lung cancer and to which patients would respond to a new type of medication. Most oncologists will now use genetic data to identify high risk patients. But the real question is will they withhold chemotherapy in those patients that are considered low risk by the gene profile? This would take a real leap of faith to not provide known health improving drugs or treatments based on this study alone!

The advances of science are like miracles, however, and we continue to develop better outcomes for cancer patients. Genetic research is advancing rapidly and will soon be increasingly more useful. In the meantime, if you have breast cancer, you might want to discuss the concept of gene profiling with your physician before chemotherapy.