ASCO Breast Cancer Biomarkers GUIDELINES App
Issue link: https://eguideline.guidelinecentral.com/i/1124845
Diagnosis Early-Stage Invasive Breast Cancer with Known ER/PgR and HER2 Status Oncotype DX ➤ If a patient has ER/PgR-positive, HER2-negative (node-negative) breast cancer, the clinician may use the 21-gene recurrence score (RS; Oncotype DX; Genomic Health, Redwood City, CA) to guide decisions on adjuvant systemic chemotherapy. (Strong Recommendation; EB-H) ➤ If a patient has ER/PgR-positive, HER2-negative (node-positive) breast cancer, the clinician should NOT use the 21-gene RS to guide decisions on adjuvant systemic chemotherapy. (Moderate Recommendation; EB-I) ➤ If a patient has HER2-positive breast cancer or triple negative (TN) breast cancer, the clinician should NOT use the 21-gene triple negative (RS) to guide decisions on adjuvant systemic therapy. (Strong Recommendation; IC-Ins) Endopredict ➤ If a patient has ER/PgR-positive, HER2-negative (node-negative) breast cancer, the clinician may use the 12-gene risk score (EndoPredict; Sividon Diagnostics, Köln, Germany) to guide decisions on adjuvant systemic chemotherapy. (Moderate Recommendation; EB-I) ➤ If a patient has ER/PgR-positive, HER2-negative (node-positive) breast cancer, the clinician should NOT use the 12-gene risk score (EndoPredict) to guide decisions on adjuvant systemic chemotherapy. (Moderate Recommendation; EB-Ins) ➤ If a patient has HER2-positive breast cancer or TN breast cancer, the clinician should NOT use the 12-gene risk score (EndoPredict) to guide decisions on adjuvant systemic therapy. (Strong Recommendation; IC-Ins) MammaPrint ➤ If a patient has ER/PgR-positive, HER2-negative, node-negative, breast cancer, the MammaPrint assay (MammaPrint; Agendia, Irvine, CA) may be used in those with high clinical risk per MINDACT categorization to inform decisions on withholding adjuvant systemic chemotherapy due to its ability to identify a good prognosis population with potentially limited chemotherapy benefit. (Strong Recommendation; EB-H) ➤ If a patient has ER/PgR-positive, HER2-negative, node-negative, breast cancer, the MammaPrint assay should NOT be used in those with low clinical risk per MINDACT categorization to inform decisions on withholding adjuvant systemic chemotherapy since women in the low clinical risk category had excellent outcomes and did not appear to benefit from chemotherapy even with a genomic high risk cancer. (Strong Recommendation; EB-H)