- With Mayo Clinic medical oncologist
Timothy J. Moynihan, M.D.
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Timothy J. Moynihan, M.D.
Timothy Moynihan, M.D.
"As a practicing medical oncologist, I meet with patients and families every day to help manage their course through this disease called cancer. This experience provides unique insight into the needs of cancer patients, their families and loved ones and brings into sharp focus the need for reliable information to be readily available in terms that can be easily understood." — Dr. Timothy Moynihan
Dr. Timothy Moynihan believes that providing consumers with accurate, timely information on the broad, complex topic of cancer is the biggest challenge facing medical websites. As the guiding force behind our cancer content, he makes sure Mayo Clinic meets the test.
Dr. Moynihan, born in Las Vegas, N.M., and raised in Denver, is a consultant in medical oncology at Mayo Clinic and an associate professor at Mayo Clinic College of Medicine, Rochester, Minn. He's board certified in internal medicine, medical oncology, and hospice and palliative care medicine.
He did his medical oncology training at Johns Hopkins Hospital in Baltimore, and then went on to the University of Minnesota and St. Paul Regions Medical Center for seven years before moving to Mayo Clinic in 1999. Dr. Moynihan is medical director of the Mayo Clinic hospice.
Dr. Moynihan serves as the education chair for the Department of Oncology and the fellowship program director. Four times he has been selected as Teacher of the Year in medical oncology and elected to the Teacher of the Year Hall of Fame.
Past honors include distinguished clinical teacher at the University of Minnesota Medical School, best internist at the Medical College of Wisconsin and recipient of the Upjohn Achievement Award for Excellence in Medicine. Dr. Moynihan serves on several national committees for the American Society of Clinical Oncology.
"The Internet provides a ready source of information on a wide range of topics of interest to those affected by cancer," Dr. Moynihan says. "The difficulty is trying to decide which sites provide reputable information and which information is relevant to each individual patient. The long history and tradition of excellence associated with Mayo Clinic assures you that information provided will be reliable, up-to-date and comprehensive."
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Question
Gene expression profiling for breast cancer: What is it?
I've been diagnosed with early-stage breast cancer. I've heard that a gene expression profiling test might help in planning my treatment. What is it?
Answer
from Timothy J. Moynihan, M.D.
Gene expression profiling tests are used in an attempt to determine the right treatment for the right person with early-stage breast cancer — cancer that may have spread to nearby lymph nodes but not to distant parts of the body. Gene expression profiling is designed to allow people who don't need additional treatment (adjuvant therapy) to avoid the side effects of unnecessary treatment, and for those who may benefit from adjuvant therapy to receive it. A gene expression profiling test analyzes the patterns of a number of different genes within the cancer cells to help predict how likely it is that an early-stage breast cancer will recur after initial treatment.
There are a few gene expression profiling tests currently available. Here's a list of those available in the United States or in Europe:
- MammaPrint. This test is designed to help determine how likely early-stage lymph node negative breast cancers are to recur elsewhere in your body.
- MapQuant DX. This test is designed to predict the risk of recurrence of certain types of estrogen receptor positive breast cancer.
- Oncotype DX. This test is used to help determine whether to use chemotherapy after surgery to treat early-stage estrogen receptor positive, lymph node negative breast cancers with a low chance of recurrence.
- Theros CancerType ID. This test is designed to help identify women with estrogen receptor positive breast cancer who are at high risk of recurrence and help predict their response to endocrine adjuvant therapy.
Other tests are in development.
The effectiveness of gene expression profiling is still being studied in a number of clinical trials. And while some doctors are using gene expression profiling to plan treatment, others are waiting for the results of these studies. Discuss with your doctor the pros and cons of gene expression profiling. These tests are not for people with more advanced breast cancer that has spread to distant parts of the body.
Next questionCoping with pain after breast surgery
- How is breast cancer diagnosed? American Cancer Society. http://www.cancer.org/docroot/cri/content/cri_2_4_3x_how_is_breast_cancer_diagnosed_5.asp. Accessed April 22, 2010.
- Multiparameter gene expression tests for breast cancer. Lab Tests Online. http://www.labtestsonline.org/understanding/analytes/breast_genex/glance-3.html. Accessed April 22, 2010.
- Hays DF, et al. Measurement of prognostic factors in breast cancer. http://www.uptodate.com/home/index.html. Accessed April 22, 2010.
- Sotiriou C, et al. Gene-expression signatures in breast cancer. New England Journal of Medicine. 2009;360:790.
- de Snoo F, et al. Gene expression profiling: Decoding breast cancer. Surgical Oncology. 2009;18:366.
- Early-stage breast cancer treatment: A patient and doctor dialogue. The National Women's Health Information Center. http://www.womenshealth.gov/faq/early-stage-breast-cancer.cfm#c. Accessed April 28, 2010.
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