Diagnosis
➤ (Update of 2016 recommendation 1.8) If a patient has HER2-positive
breast cancer, the clinician should NOT use the MammaPrint assay
to guide decisions regarding adjuvant systemic therapy. (Moderate
Recommendation; IC-L)
• Additional studies are required to address the role of MammaPrint in patients with this
tumor subtype who are also receiving HER2-targeted therapy.
➤ (Update of 2016 recommendation 1.9) If a patient has ER/PgR negative and
HER2-negative breast cancer (triple negative), the clinician should NOT
use the MammaPrint assay to guide decisions about adjuvant systemic
chemotherapy. (Strong Recommendation; IC-Ins)
PAM50 Risk of Recurrence Score
➤ If a patient has ER/PgR-positive, HER2-negative (node-negative) breast
cancer, the clinician may use the PAM50 risk of recurrence (ROR) score
(Prosigna Breast Cancer Prognostic Gene Signature Assay; NanoString
Technologies, Seattle, WA), in conjunction with other clinicopathologic
variables, to guide decisions on adjuvant systemic therapy. (Strong
Recommendation; EB-H)
➤ If a patient has ER/PgR-positive, HER2-negative (node-positive) breast
cancer, the clinician should NOT use the PAM50-ROR to guide decisions
on adjuvant systemic therapy. (Moderate Recommendation; EB-I)
➤ If a patient has HER2-positive breast cancer, the clinician should NOT use
the PAM50-ROR to guide decisions on adjuvant systemic therapy.
(Strong Recommendation; IC-Ins)
➤ If a patient has TN breast cancer, the clinician should NOT use the
PAM50-ROR to guide decisions on adjuvant systemic therapy. (Strong
Recommendation; IC-Ins)
Breast Cancer Index
➤ If a patient has ER/PgR-positive, HER2-negative (node-negative) breast
cancer, the clinician may use the Breast Cancer Index to guide decisions
on adjuvant systemic therapy. (Moderate Recommendation; EB-I)
➤ If a patient has ER/PgR-positive, HER2-negative (node-positive) breast
cancer, the clinician should NOT use the Breast Cancer Index to guide
decisions on adjuvant systemic therapy. (Strong Recommendation; IC-Ins)
➤ If a patient has HER2-positive breast cancer or TN breast cancer, the
clinician should NOT use the Breast Cancer Index to guide decisions on
adjuvant systemic therapy. (Strong Recommendation;IC-Ins)
