Genomic Testing in Women with Early-Stage Hormone Receptor–Positive, HER2–Negative Breast Cancer

Sima Ehsani, MD

Assistant Professor of Medicine, Division of Hematology/Medical Oncology, University of Arizona Cancer Center, Tucson, AZ

Kari Braun Wisinski, MD

Associate Professor, Department of Medicine, University of Wisconsin Carbone Cancer Center, Madison, WI

Question 1

A 48-year-old premenopausal woman presents with a mammogram-detected right breast invasive ductal carcinoma (IDC), grade II, positive for both estrogen and progesterone receptors (ER and PR) and HER2-negative. Ki-67 is 15%. She undergoes a partial mastectomy and sentinel lymph node biopsy (SLNB), with pathology showing a 2.1-cm tumor, no lymphovascular invasion, negative margins, and 1 out of 2 SLNs positive for metastasis. Complete blood count and comprehensive metabolic panel are unremarkable. Which of the following tests will help estimate this patient's risk for distant breast cancer recurrence?

  •   A baseline serum CA 27-29
  •   Breast Cancer Prognostic Gene Signature (PAM50) assay
  •   21-gene assay (Oncotype DX)
  •   None of the above, as the prognostic value of genomic tests has not been validated in node-positive breast cancers

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