Women Diagnosed With Breast Cancer Consider Genomic Tests Hugely Important, but Many Don’t Understand Results

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A genomic test (also called a genomic assay or a gene expression profile test) analyzes the activity of a group of genes linked to the risk of a particular disease. The tests are done on blood or tissue samples. For example, a genomic test may help figure out if a woman diagnosed with early-stage hormone-receptor-positive cancer has a high, medium, or low risk of recurrence (the cancer coming back), as well as if she’s likely to benefit from chemotherapy to reduce that risk.

A very small study suggests that women diagnosed with early-stage breast cancer consider genomic test results very important when deciding whether to have chemotherapy, but many of them don’t fully understand what the test results mean.

The research was published in the January 2014 issue of Current Oncology. Read “Patients’ perceptions of gene expression profiling in breast cancer treatment decisions.”

Currently there are several genomic tests used to analyze breast cancer genes to predict recurrence, including the Oncotype DX test, the MammaPrint test, the Breast Cancer Index test, the EndoPredict test, and the Prosignia Breast Cancer Prognostic Gene Signature Assay.

While all the tests are somewhat similar, there are differences:

  • 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 person 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 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 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 EndoPredict test is used to predict the risk of distant recurrence of early-stage, hormone-receptor-positive, HER2-negative breast cancer that is either node-negative or has up to three positive lymph nodes.
  • The Prosigna Breast Cancer Prognostic Gene Signature Assay 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.

Genomic test results, when considered with other features of the breast cancer, can help you and your doctor make a more informed decision about whether to use chemotherapy or other treatments to reduce the risk of recurrence.

This study involved 28 women who had been diagnosed with early-stage breast cancer (stage I or stage II) and had genomic testing. To learn what the women thought about the genomic testing, the researchers interviewed 24 of the women and conducted a focus group with the other four women.

The researchers asked the women about:

  • how the genomic test results were used in the treatment decision-making process
  • their attitudes toward and understanding of the test results
  • other factors that affected the treatment decision-making process

The researchers found that the women understood that the genomic test would suggest whether they would benefit from chemotherapy. Still, many of the women thought that the test results were more scientifically valid, more personalized, and more emotionally significant than other information they had been given about breast cancer.

In reality, genomic test results are based on larger population statistics and are not more personalized than other test results. Genomic test results are one of many factors that women and their doctors use to make treatment decisions. Other factors include:

  • your age
  • your menopausal status
  • the size of the cancer
  • hormone-receptor protein levels
  • cancer grade
  • HER2 status
  • your personal preferences

Armed with the best information possible, you and your doctor can decide on a treatment plan that makes the most sense for you and your unique situation.

Editor's note: This article was originally published on June 25, 2014, and has been updated. Since this research was published, new genomic tests have come to market. For the most up-to-date information, visit the Breastcancer.org Breast Cancer Tests page.


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