The NHS could save £4 million a year by offering women with low-risk breast cancer a genetic test that may help them avoid unnecessary and toxic chemotherapy.
Known as Prosigna, the test is currently approved only for post-menopausal women whose cancer has spread to no more than three nearby lymph nodes.
However, experts at University College London say extending access to women as young as 40 could save the NHS £654 per patient.
The wider use of the test could also spare more than 4,000 women each year from chemotherapy side effects, including nausea, vomiting, hair loss and a heightened risk of infection.
Presenting the findings at the annual meeting of the European Society for Medical Oncology in Madrid, Dr Rob Stein said: ‘Prosigna testing not only allows about two-thirds of patients with this type of breast cancer to safely avoid chemotherapy, but doing so also saves the NHS money.’
The study examined the first two years after diagnosis, although experts believe the long-term savings could be even greater.
Breast cancer is the most common cancer among women worldwide. In the UK alone, around 60,000 women are diagnosed with invasive breast cancer every year.
About 80 per cent of these tumours are oestrogen-receptor positive. This means they are driven by the female sex hormone oestrogen and may be treated with hormone-blocking drugs alone.
Wider access to genetic testing could save the NHS £4 million a year while sparing thousands of women the debilitating side effects of chemotherapy
Despite this, many patients are also offered chemotherapy because the treatment can reduce the risk of the cancer returning.
There is growing concern, however, that many women receive little or no benefit from chemotherapy while still enduring its debilitating and, in some cases, dangerous side effects.
UCL experts say Prosigna could help doctors and patients navigate this difficult treatment decision.
The OPTIMA trial involved 4,429 women aged 40 and over whose breast cancer had spread to up to nine lymph nodes or who had a tumour measuring at least 30mm. All were given the test.
Prosigna examines the activity of 50 genes linked to breast cancer growth. The genetic material is taken from the tumour during a standard biopsy or surgery.
The analysis produces a score reflecting the risk of the cancer spreading. A low score indicates that hormone therapy alone may be a safe treatment option.
The results showed that 67 per cent of the women tested could avoid chemotherapy.
UCL analysis suggests this would equate to around 4,200 patients each year.
The trial also found that, during the two years after diagnosis, standard chemotherapy costs the NHS approximately £5,500 per patient.
This estimate includes the cost of the drugs, nursing care, hospital time, medicines used to control side effects and any hospital admissions resulting from treatment.
Professor Peter Hall of the University of Edinburgh found that using Prosigna reduced those costs by £3,611 per patient.
In the UK, the test is estimated to cost the NHS around £1,955 per patient.
After considering other factors including any additional costs that might have been incurred from patients who skip chemotherapy to start other treatments sooner, Prof Hall calculated that the NHS could save around £654 per patient, by offering the Prosigna test within the first two years of being diagnosed.
Over the course of a year, if the NHS gave the test to all women who met the trial criteria, the health service could save around £4 million.
