The latest version of the NCCN breast cancer guidelines incorporates the use of genomic expression profiling to assist in adjuvant treatment decision making in women with hormone receptor (HR)– positive, HER2-negative breast cancer.

Genomic profiling has been found to successfully predict the benefit of endocrine therapy, as was demonstrated in the TAILORx study, said Lee S. Schwartzberg, MD. The study utilized the 21-gene recurrence score (Oncotype DX) to determine the risk of recurrence.4 Patients with a score ≤11 had a lower risk of their breast cancer returning. The study found that patients with breast cancer whose tumors had a favorable gene-expression profile had very low rates of recurrence at 5 years following treatment with endocrine therapy.

The 21-gene recurrence score has also been found to be prognostic in women with node-positive cancer, although its predictive value in this group remains uncertain, said Schwartzberg, executive director, West Cancer Center and chief, Division of Hematology/Oncology, University of Tennessee Health Science Center.

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