University of California San Francisco
Helen Diller Family Comprehensive Cancer Center

Test Identifies Breast Cancer Patients with Lowest Risk of Death

Long-term Survival with Minimal Treatment Seen in Ultralow Risk Patients, UCSF Study Finds

By Elizabeth Fernandez | | June 29, 2017

Test Identifies Breast Cancer Patients with Lowest Risk of Death

breast cancer tumor and its microenvironment/ photo: NCI

A molecular test can pinpoint which patients will have a very low risk of death from breast cancer even 20 years after diagnosis and tumor removal, according to a new clinical study led by UC San Francisco in collaboration with colleagues in Sweden. As a result, “ultralow” risk patients could be treated less aggressively and overtreatment avoided, leading to fewer toxic effects. 

“This is an important step forward for personalizing care for women with breast cancer,” said lead author Laura J. Esserman, MD, MBA, a breast cancer specialist and surgeon with UC Health. “We can now test small node-negative breast cancers, and if they are in the ultralow risk category, we can tell women that they are highly unlikely to die of their cancers and do not need aggressive treatment, including radiation after lumpectomy.”

Oncologist have discussed the existence of ultralow risk tumors and expressed concern that they might be exacerbated by screening. But, Esserman said, this is the first evidence that it is possible to run a diagnostic test at the time of diagnosis and identify them. The study appears June 29, 2017, in JAMA Oncology.

“This is an exciting advance because approximately 20-25 percent of tumors diagnosed today may be ultralow risk,” said Esserman, a UCSF professor and director of the UCSF Carol Franc Buck Breast Care Center who also co-leads the breast oncology program at the UCSF Helen Diller Family Comprehensive Cancer Center (HDFCCC).