10
Diagnosis
Figure 1. Algorithm on Biomarkers to Guide Decisions
on Adjuvant Endocrine and Chemotherapy
Node+
Oncotype DX
uPA and PAI-1
d
Insufficient
evidence to
recommend a
biomarker for use
No mature evidence to
recommend use of any
other biomarker for this
patient population
HER2+
Node–
a
Only in patients with high clinical risk per MINDACT categorization.
b
Only if locally validated and together with other parameters in patients who do not have access
to genomic tests.
c
May also be offered to patients who received 5 years of endocrine therapy without evidence of
recurrence.
d
is biomarker is no longer in use.
BCI, Breast Cancer Index; ER, estrogen receptor; HER2, human epidermal growth factor receptor 2;
IHC4, immunohistochemistry 4; NEG, negative; POS, positive; PR, progesterone receptor
Premenopausal
or age ≤50 years
Women with early-stage
invasive breast cancer
HER2–
ER+
