Abstract
In recent years, developments in breast cancer have allowed yet another realization of individualized medicine in the field of oncology. One of these advances is genomic assays, which are considered elements of standard clinical practice in the management of breast cancer. These assays are widely used today not only to measure recurrence risk in breast cancer patients at an early stage but also to tailor treatment as well and minimize avoidable treatment side effects. At present, genomic tests are applied extensively in node negative disease. In this article, we review the use of these tests in node positive disease, explore their ramifications on neoadjuvant chemotherapy decisions, highlight sufficiently powered recent studies emphasizing their use and review the most recent guidelines.
Highlights
We have come a long way in the emerging genomic paradigm! We are no longer at crossroads in the management of malignancies, especially breast cancer (BCA)
For women older than 50 years with an recurrence score (RS) of 26–100 or women less than 50 years with an RS of 26–100, it is probable that the benefits of CT will compensate the risks of adverse effects, and that BCA has a high risk of recurrence (RoR) (8)
BCA mortality has been reduced over the past years thanks to improved prognostic and predictive information aiding in decision-making
Summary
We have come a long way in the emerging genomic paradigm! We are no longer at crossroads in the management of malignancies, especially breast cancer (BCA). With the progresses in BCA screening techniques, cancer detection rate has improved This has led to a decrease in mortality from BCA due to both earlier detection and systemic individualized treatments (5). Genomic Assays in Node Positive Disease of cases of ER +ve BCA fall in between these two extremes and warrant gene expression profiles for further decision-making (8). Before discussing the different biomarker assays used to lead conclusions on adjuvant systemic treatment related to females with early invasive disease, it’s imperative to differentiate between prognostic and predictive biomarkers (9, 10). The former reflects disease recurrence or progression independent of any therapy received (10, 11). We limit our discussion to the most commonly used genomic assays
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