How Personalized Medicine Played a Role in Ashliann’s Breast Cancer Journey
A young mother shares her experiences with the Breast Cancer Index® test, which can help patients with early-stage hormone receptor–positive (HR+) breast cancer and their doctors decide whether to extend anti-estrogen therapy past the five-year mark based on the likelihood of benefit.
Ashliann and her family.
Ashliann Mazeika was getting ready for a day of house-hunting with her husband when she noticed an unusual lump in her breast. Mazeika, then 24 years old and newly married, made an appointment with her OB-GYN for the following day. A week later she learned she had early-stage breast cancer.
Breast cancer is the most common cancer among U.S. women after skin cancer.1 For many, diagnosis is followed by a whirlwind of information and complex decisions about surgery, radiation, chemotherapy and medications. A person’s overall health, menopausal status, personal preferences and increasingly, their unique genetics all play a role in determining a treatment plan to eliminate the cancer and reduce the risk of it returning.
The Breast Cancer Index test: A predictive tool
Mazeika underwent a double mastectomy and aggressive chemotherapy and then began taking tamoxifen, a type of therapy that blocks estrogen activity to stop the growth of tumors. Though it can greatly reduce the chances of hormone receptor-positive breast cancer returning, anti-estrogen (or endocrine) therapy can cause numerous side effects. For Mazeika, these included memory problems, mood changes, hot flashes and trouble sleeping — all of which improved when she stopped taking the drug after five years and became pregnant.
After having her son, Mazeika talked with her doctor about finishing the remaining five years of recommended tamoxifen to reduce the risk of recurrence. “I was dreading going back on it because I felt so much better when I was pregnant,” said Mazeika. That’s when a member of her care team told her about the Breast Cancer Index test.
The test, which uses tissue taken from the original biopsy or during surgery, is identified by the NCCN Clinical Practice Guidelines in Oncology (NCCN® Guidelines) and the ASCO® Clinical Practice Guideline as the only test to predict which women with early-stage hormone receptor–positive (HR+) breast cancer are likely to benefit from continuation of endocrine therapy beyond five years.2-3 Studies show that while a longer duration of therapy helps some women reduce their risk of recurrence after the five-year mark, as many as 95 percent of women do not benefit.4-9 The Breast Cancer Index test can help oncology care teams and patients navigate the difficult trade-offs between taking steps to reduce the risk of recurrence of their disease while facing potentially significant side effects.
Quote from Kai Treuner
"We are amplifying specific genes of interest — biomarkers that have been shown to be important in breast cancer to measure the aggressiveness of the tumor and whether the patient is likely to benefit from more endocrine therapy. The test provides a straight-forward calculation and a level of certainty that physicians would not have if they didn't incorporate the tumor biology.”
An informed decision
Mazeika’s results showed a high risk of recurrence, along with a straightforward “yes” result indicating that taking tamoxifen for an additional five years was likely to help reduce that risk.
“I knew the test was giving me an answer that was specific to my situation rather than just sticking with the standard protocols,” said Mazeika, reflecting on her decision to do the test and to complete the additional five years of treatment.
“Of course, I was hoping I wasn’t going to have to take more tamoxifen — but either way I knew regardless of the results, I would have peace of mind.”
A paradigm shift toward personalized medicine
Today, Ashliann is in remission and enjoying spending time with her husband and young son. She recently finished her treatment with tamoxifen and has no regrets about her decision.
Tools like the Breast Cancer Index test support a growing shift toward more personalized cancer treatments through a precision medicine approach, which looks at individual differences in genes, environment and lifestyle to inform medical decisions and treatment.
“I think one of the greatest advances in oncology over the last several decades is this deeper understanding of someone’s specific tumor biology that in combination with other clinical factors, allows for a more tailored care approach,” said Treuner. “With tests like the Breast Cancer Index, we can help providers better determine the right length of treatment to create the best overall clinical scenario for each patient.”