Use of Biomarkers and Multigene Assays in Breast Cancer

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Lee S. Schwartzberg Presented by Lee S. Schwartzberg, MD, West Cancer Center, and Division of Hematology/Oncology, University of Tennessee Health Science Center, Memphis, Tennessee.

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All patients with early breast cancer should be classified by subgroup through testing estrogen receptor, progesterone receptor, and HER2 status, with or without Ki-67 proliferation percentage. Genomic expression profiling aids clinical decision-making in most patients, because most are estrogen receptor–positive. The commercially available classifiers are prognostic for distant recurrence in node-negative and also node-positive patients. Patients at genomically low risk have excellent 5-year outcomes with endocrine therapy alone. Some assays also predict for benefit from adjuvant endocrine therapy and chemotherapy in node-negative and node-positive patients, but with varying levels of evidence. Genomic classifiers are also prognostic of late relapse and may predict benefit from extended adjuvant endocrine therapy.

Correspondence: Lee S. Schwartzberg, MD, West Cancer Center, 7945 Wolf River Boulevard, Memphis, TN 38138. E-mail: lschwartzberg@westclinic.com
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