4
Diagnosis
MammaPrint (70-gene signature)
Recommendation 1.8
➤ If a patient is older than 50 and has high clinical risk breast cancer
that is node-negative or node-positive with 1–3 positive nodes, the
clinician may use MammaPrint test to guide decisions for adjuvant
endocrine and chemotherapy. (Strong recommendation; EB-I)
Recommendation 1.9
➤ If a patient is 50 years of age or younger and has high clinical risk,
node-negative or node-positive with 1–3 positive nodes breast cancer,
the clinician should NOT use the MammaPrint test to guide decisions for
adjuvant endocrine and chemotherapy. (Strong recommendation; EB-H).
Recommendation 1.10
➤ If a patient has low clinical risk, regardless of age, the evidence
on clinical utility of routine MammaPrint test is insufficient to
recommend its use. (Moderate recommendation; EB-I).
Recommendation 1.11
➤ If a patient has node-positive breast cancer with more than 3 positive
nodes, the evidence on the clinical utility of routine MammaPrint
test to guide decisions for adjuvant endocrine and chemotherapy is
insufficient to recommend its use. (Strong recommendation; IC-Ins).
Qualifying statement: The genomic assay is prognostic and may be used for shared
patient-physician treatment decision making.
EndoPredict (12-gene risk score)
Recommendation 1.12
➤ If a patient is postmenopausal and has breast cancer that is node-
negative or node-positive with 1–3 positive nodes, the clinician may
use EndoPredict test to guide decisions for adjuvant endocrine and
chemotherapy. (Moderate recommendation; EB-I)
Recommendation 1.13
➤ If a patient is premenopausal and has breast cancer that is node-
negative or node-positive with 1–3 positive nodes, the clinician should
NOT use EndoPredict test to guide decisions for adjuvant endocrine
and chemotherapy. (Moderate recommendation; IC-Ins)
Recommendation 1.14
➤ If a patient has breast cancer with more than 3 positive nodes,
evidence on the clinical utility of routine use of EndoPredict test
to guide decisions for adjuvant endocrine and chemotherapy is
insufficient. (Moderate recommendation; EB-I)
