How do you utilize genomic testing in HR positive breast cancer to make recommendations regarding the duration of endocrine therapy?  

Extending HRT from 5 to 10 years, whether with a SERM or an AI, reduces the risk of recurrence and new breast cancers. BUT the benefit is small and the toxicity is not inconsequential, making decisions challenging. Oncotype was developed to identify patients who would benefit from chemotherapy. As c...

The Breast Cancer Index (BCI) reports a risk assessment score, which is a prognostic score that estimates the risk of recurrence in the next 10 years, and it also has a response to therapy result (H/I ratio), which was designed to estimate the likelihood that a patient would benefit from extended en...

Several genomic prognostic assays appear to predict late relapse (BCI, Prosigna, EPclin), while others perform less well at this (MammaPrint, Oncotype Dx). BCI predicted EET benefit in MA.17. However, none of these assays have demonstrated that they add value beyond thoughtful clinical ascertainment...

I have not fully adopted monitoring for ESR1 mutation in patients on the first-line endocrine therapy who have no evidence of progression in imaging. I do use CA15-3 as one of several ways to follow treatment response. When a patient has a rising CA15-3, I perform imaging, but rarely change treatmen...

I typically use Breast Cancer Index around year 4 or 5 for ER+, T1-2 patients with up to 3 positive nodes who have completed 5 years of therapy without recurrence to determine the benefit of extending endocrine therapy to 10 years. For patients with more than 4 positive nodes, we know from meta-anal...