7
Extended Endocrine Therapy For ER Receptor-positive
HER2-negative Breast Cancer
Oncotype DX, EndoPredict, Prosigna, Ki67, or IHC4
Recommendation 1.23
➤ If a patient has node-negative breast cancer and has had 5 years
of endocrine therapy without evidence of recurrence, there is
insufficient evidence to use Oncotype DX, EndoPredict, Prosigna,
Ki67, or IHC4 tests to guide decisions about extended endocrine
therapy. (Moderate recommendation; EB-I)
BCI
Recommendation 1.24
➤ If a patient has node-negative or node-positive with 1–3 positive
nodes breast cancer and has been treated with 5 years of primary
endocrine therapy without evidence of recurrence, the clinician may
offer BCI test to guide decisions about extended endocrine therapy
with either tamoxifen, an AI, or a sequence of tamoxifen followed by
AI. (Moderate recommendation; EB-I)
Recommendation 1.25
➤ If a patient has node-positive breast cancer with more than 3 positive
nodes and has been treated with 5 years of primary endocrine therapy
without evidence of recurrence, there is insufficient evidence to use
BCI test to guide decisions about extended endocrine therapy with
either tamoxifen, an AI, or a sequence of tamoxifen followed by AI.
(Strong recommendation; EB-I)
Clinical Treatment Score post-5 Years (CTS5)
Recommendation 1.26
➤ If a patient is postmenopausal and had invasive breast cancer and
is recurrence free after 5 years of adjuvant endocrine therapy,
the CTS5 web tool may be used to calculate the estimated risk
of late recurrence (recurrence between years 5–10), that could
assist in decisions about extended endocrine therapy. (Moderate
recommendation; EB-I)
