Recurrence score

My Mom, age 68, is newly diagnosed with stage 1 breast cancer.  Her tumor is small, Er=positive, Pr=positive and Her2=positive.  She would really like to avoid chemotherapy after the lumpectomey beyond tamoxifen for hormone therapy.  We have recently heard about a new test for women with lower-stage tumors (stage 1 or 2) to estimate the probability of the tumor coming back as metastatic cancer.  The nurse who told us about  it (on an airplane) said the test gives you a recurrence score based on the genetics of the tumor cells.  This score apparently is a reliable indicator of the chances the cancer will return later in life.  The nurse was not sure whether this test is available, or in research still -- she heard about it a big cancer medicine meeting in Texas.  Do you know anything about this test?  Is is available?  Is it truly reliable?  Do you know how much it costs?  If my Mom got the test and got a low-risk score, should she agree to chemotherapy anyway?  Her doctor does not know about this test and is inclined to recommend chemo. based on his standard practice for patients like my Mom.  I am an only child, my Dad has passed on, and my Mom is asking for my help with these decisions.

[CCF-RN,MSN-JS]

Dear SonofCarol, The test that you likely heard about was reported at the San Antonio Breast Symposium December 2003.  The test - the described certain genetic characteristics of tumors from archived specimens.   The gene information was compared with what happened to these women over the years.  There were some interesting results that may be helpful to identify women with early stage breast cancer who would benefit most from chemotherapy and those for whom chemotherapy may not be needed. However, this research was looking at past specimens and how women did based on records.  The next step will be to look at this information in a prospective way, by pursuing this information in clinical trials.  More research needs to be done regarding this before we know if it translates into something that will be helpful in predicting whether or not a person will benefit or not from chemotherapy.  The current recommendation is to give adjuvant chemotherapy if the primary tumor is greater than 1cm, regardless of nodal status, because of an overall improvement in survival.