美国国家公共电台 NPR Tumor Test Helps Identify Which Breast Cancers Don't Require Extra Treatment

 

DAVID GREENE, HOST:

We've been looking at some new research in the medical journal JAMA Oncology. It finds that women with early-stage, low-risk breast cancer may be able to skip follow-up treatments like hormone¹ therapy and radiation after they have had surgery to remove the cancer. Here's NPR's Patti Neighmond.

PATTI NEIGHMOND, BYLINE²: For years, doctors have known there are big differences in breast cancers. Some are aggressive and life-threatening. Others are not. Breast cancer surgeon Laura Esserman.

LAURA ESSERMAN: But if you can't identify them, and you can't tell which is which, you give everyone the treatment because you're afraid to miss somebody.

NEIGHMOND: So after diagnosis³, most patients have surgery, often followed by radiation chemotherapy or hormone therapy. Side effects can be severe. Esserman, a cancer researcher at the University of California, San Francisco, teamed up with Swedish doctors to look at how a test which biologically measures a tumor⁴'s aggression⁵ might identify patients at low risk of having cancer return. The test worked, and Esserman was able to pinpoint⁶ patients at very low risk of having cancer return even up to 20 years after diagnosis.

ESSERMAN: You can really say to someone, you're not going to die of this disease. And we don't have to be aggressive up front and treat you with everything just in case.

NEIGHMOND: Esserman looked at medical records from 652 Swedish patients who had a mastectomy or lumpectomy plus radiation. The tumor test found that 15 percent of them were classified as ultra-low-risk tumors. About half of the women got no further their treatment. About half got the hormone blocker tamoxifen. After 20 years, nearly all were still alive. The results build on findings from a 2016 study that showed nearly half of women with low-risk cancer could actually skip chemotherapy and not have their cancer return.

ESSERMAN: This ultra-low-risk designation really identifies people with an extremely low risk for recurrence⁷ or death from breast cancer. And so that means that, up front, we can say, you don't need all that treatment. It's a great thing to be able to tell people.

NEIGHMOND: Esserman says it now appears about 20 to 25 percent of breast cancer tumors diagnosed today aren't ever going to cause problems and don't need treatment after surgery. Dr. Len Lichtenfeld with the American Cancer Society says the findings concur⁸ with growing evidence in many different cancers.

LEN LICHTENFELD: This study shows us that biology matters. And that's an evolving theme that has been talked about for several years in cancer care.

NEIGHMOND: Using science, he says, to understand that, sometimes, less treatment is highly effective.

LICHTENFELD: We used to think that every cancer we found was a bad cancer. And we used to think that every cancer we found had to be treated aggressively. It's taken a long time for us to begin to understand and adopt those principles that we can treat less and still be effective.

NEIGHMOND: The tumor test researchers used is called MammaPrint. It's a genomic test that looks at a set of 70 genes⁹ and a tumor which control production of proteins that drive the tumor's growth. It costs about $4,000 and is sometimes covered by insurance. It measures how genes are functioning and differs from genetic¹⁰ tests that determine someone's hereditary¹¹ risk of cancer. Patti Neighmond, NPR News.

(SOUNDBITE OF PORT BLUE'S "CITY OF SAFE HARBORS")

1 hormone   

n.荷尔蒙，激素，内分泌

参考例句：

• Hormone implants are used as growth boosters.激素植入物被用作生长辅助剂。
• This hormone interacts closely with other hormones in the body.这种荷尔蒙与体內其他荷尔蒙紧密地相互作用。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

4 tumor   

n.（肿）瘤，肿块(英)tumour

参考例句：

• He was died of a malignant tumor.他死于恶性肿瘤。
• The surgeons irradiated the tumor.外科医生用X射线照射那个肿瘤。

5 aggression   

n.进攻，侵略，侵犯，侵害

参考例句：

• So long as we are firmly united, we need fear no aggression.只要我们紧密地团结，就不必惧怕外来侵略。
• Her view is that aggression is part of human nature.她认为攻击性是人类本性的一部份。

6 pinpoint   

vt.准确地确定；用针标出…的精确位置

参考例句：

• It is difficult to pinpoint when water problems of the modern age began.很难准确地指出，现代用水的问题是什么时候出现的。
• I could pinpoint his precise location on a map.我能在地图上指明他的准确位置。

7 recurrence   

n.复发，反复，重现

参考例句：

• More care in the future will prevent recurrence of the mistake.将来的小心可防止错误的重现。
• He was aware of the possibility of a recurrence of his illness.他知道他的病有可能复发。

8 concur   

v.同意，意见一致，互助，同时发生

参考例句：

• Wealth and happiness do not always concur.财富与幸福并非总是并存的。
• I concur with the speaker in condemning what has been done.我同意发言者对所做的事加以谴责。

9 genes   

n.基因( gene的名词复数 )

参考例句：

• You have good genes from your parents, so you should live a long time. 你从父母那儿获得优良的基因，所以能够活得很长。 来自《简明英汉词典》
• Differences will help to reveal the functions of the genes. 它们间的差异将会帮助我们揭开基因多种功能。 来自英汉非文学 - 生命科学 - 生物技术的世纪

10 genetic   

adj.遗传的，遗传学的

参考例句：

• It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
• Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。

11 hereditary   

adj.遗传的，遗传性的，可继承的，世袭的

参考例句：

• The Queen of England is a hereditary ruler.英国女王是世袭的统治者。
• In men,hair loss is hereditary.男性脱发属于遗传。