The EndoPredict Test, offered by Myriad Genetics, Inc., is a genomic test for people newly diagnosed with early-stage, estrogen-receptor-positive, HER2-negative breast cancer.
Research suggests the EndoPredict test may be widely used to help make treatment decisions based on the cancer's risk of coming back in a part of the body away from the breast (distant metastasis) within 10 years after diagnosis. The EndoPredict test provides a risk score that is either low-risk or high-risk of breast cancer recurring as distant metastasis. Knowing if the cancer has a high or low risk of recurrence can help women and their doctors decide if chemotherapy or other treatments to reduce risk after surgery are needed.
What are genomic tests?
Genomic tests analyze a sample of a cancer tumor to see how active certain genes are. The activity level of these genes affects the behavior of the cancer, including how likely it is to grow and spread. Genomic tests are used to help make decisions about whether more treatments after surgery would be beneficial.
While their names sound similar, genomic testing and genetic testing are very different.
Genetic testing is done on a sample of your blood, saliva, or other tissue and can tell if you have an abnormal change (also called a mutation) in a gene that is linked to a higher risk of breast cancer. See the Genetic Testing pages for more information.
Who is eligible for the EndoPredict test?
You may be a candidate for the EndoPredict test if:
- you’ve recently been diagnosed with stage I or II estrogen-receptor-positive, HER2-negative breast cancer
- there is no cancer in your lymph nodes (node-negative disease) OR you have cancer in one to three lymph nodes
- you and your doctor are making decisions about chemotherapy
If you’ve been diagnosed with early-stage, estrogen-receptor-positive, HER2-negative breast cancer, the EndoPredict test may help you and your doctor make a more informed decision about chemotherapy after surgery.
How does the EndoPredict test work?
The EndoPredict test analyzes the activity of 12 genes in breast cancer cells. These genes are linked to the likelihood that the cancer will come back in a part of the body away from the breast within 10 years after diagnosis.
The EndoPredict test also includes the size of the cancer and whether or not cancer is in the lymph nodes when calculating the risk score.
EndoPredict test results are given as an EPclin Risk Score, a number between 1.1 and 6.2 that maps to a percentage risk of recurrence. The scores are considered either low-risk or high-risk:
- an EPclin Risk Score higher than 3.3287 (higher than a 9% risk of recurrence) is interpreted as the cancer having a high risk of recurrence
- an EPclin Risk score lower than 3.3287 (lower than a 9% risk of recurrence) is interpreted as the cancer having a low risk of recurrence
- each EPclin Risk Score is shown on a curve to clarify an individual’s personal risk of recurrence
You and your doctor will consider the EPclin Risk Score in combination with other factors, such as the grade of the cancer, the number of hormone receptors the cancer cells have (many versus few), and your age. Together, you can make a more informed decision about chemotherapy.
The EndoPredict test is performed on preserved tissue that was removed during the original biopsy or surgery.
Insurance coverage and financial assistance
If your insurance plan doesn’t cover the EndoPredict test, talk to your doctor. Your doctor may be able to work with your insurance company to get coverage.
Myriad Genetics, the company that provides the EndoPredict test, also may be able to help you if your insurance company doesn’t cover the test or you have questions about paying for the test. You can contact Myriad by phone at 844-MYRIAD9 (844-697-4239) or by email via firstname.lastname@example.org.
Other genomic tests
There are other genomics tests used to analyze breast cancer tumors. To learn more, click on the links below.
- The Breast Cancer Index test is used to predict the risk of node-negative, hormone-receptor-positive breast cancer coming back 5 to 10 years after diagnosis.
- The MammaPrint test is used to predict the risk of recurrence within 10 years after diagnosis of stage I or stage II breast cancer that is hormone-receptor-positive or hormone-receptor-negative.
- The Mammostrat test is used to predict the risk of recurrence of early-stage, hormone-receptor-positive breast cancer.
- The Oncotype DX test is used to predict the risk of recurrence of early-stage, hormone-receptor-positive breast cancer, as well as how likely it is that a woman diagnosed with this type of cancer will benefit from chemotherapy after surgery. The Oncotype DX DCIS test is used to predict the risk of recurrence of DCIS and/or the risk of a new invasive cancer developing in the same breast, as well as how likely it is that a woman diagnosed with DCIS will benefit from radiation after surgery.
- The Prosigna Breast Cancer Prognostic Gene Signature Assay (formerly called the PAM50 test) is used to predict the risk of distant recurrence for postmenopausal women within 10 years of diagnosis of early-stage, hormone-receptor-positive disease with up to three positive lymph nodes after 5 years of hormonal therapy.