Multigene Assays: The Changing Paradigm of Personalized Medicine in Breast Cancer

Abstract

negative axillary nodes, successful treatment and a better prognosis. Intriguingly, breast cancer in young women is associated with adverse pathological factors, hormone receptor negativity, and HER2 (human epidermal growth factor receptor overexpression which explains worse outcome. 1 The screening and diagnosis of breast cancer patients at earlier stages benefits the patient, and also minimizes the financial burden. 5 The traditional clinical approach to treat both the in situ and invasive breast cancer involves the use of surgical, chemical and radiation based therapies. 6 The decision as to whether to have further chemotherapy that includes drugs such as Cyclophosphamide, 5-fluorouracil, carboplatin, taxane and anthracycline can cause considerable distress and common side effects such as anemia, nausea, vomiting, fertility issues, memory loss, menopause and menopausal problems, neuropathy, fatigue and hair loss-can be a difficult one. 7 In general, chemotherapy damages cells that are dividing, so the parts of the body such as mouth, intestines, skin, hair, and bone marrow where normal cells divide frequently are likely to be affected by chemotherapy. Most therapies which are administered to treat breast cancer are quiet toxic so it is better to select and use suitable therapy for the appropriate women. Some side effects of chemotherapy are less common but more serious medical conditions that need to be treated. 7 These include osteoporosis, heart problems and eye/vision problems. The limitations of chemotherapy, especially the narrow therapeutic index and the lack of discrimination for cancerous and non-cancerous cells have prompted the search for a greater target-directed approach to cancer treatment. Long-term side effects of chemotherapy could include damage to the heart, kidneys, lungs, nerves or reproductive organs. There is also a chance of developing a second cancer as a result of chemotherapy. 8