Some people with early breast cancer may need chemotherapy after surgery (adjuvant chemotherapy). Tumour profiling tests look at the activity of genes in tumour samples and provide information on how likely it is the cancer will come back. The test results can help you and your doctor decide whether to have adjuvant chemotherapy. If you choose to have a test, a specialist cancer doctor (oncologist) should discuss the results and treatment options with you.
Lymph node-positive early breast cancer
For oestrogen receptor (ER)- or progesterone receptor (PR)-positive, HER2-negative early breast cancer that affects 1 to 3 lymph nodes, NICE has said that:
- EndoPredict, Oncotype DX or Prosigna can be used alongside consideration of clinical risk factors to guide adjuvant chemotherapy decisions for:
- women, only if they have been through the menopause
- men
- trans, non-binary or intersex people, depending on their hormonal profile.
- MammaPrint should not be used.
If you are a man, or trans, non-binary or intersex, your healthcare professional should discuss with you whether testing is suitable.
Lymph node-negative and micrometastatic early breast cancer
For ER- or PR-positive, HER2-negative early breast cancer that does not affect the lymph nodes or where only a very small amount of cancer has spread to the lymph nodes (micrometastatic), NICE has said that:
- EndoPredict, Oncotype DX and Prosigna can be used to guide adjuvant chemotherapy decisions for people whose cancer has an intermediate risk of coming back in another area of the body.
- MammaPrint and IHC4+C should not be used.
The NHS is collecting more evidence for EndoPredict, Oncotype DX and Prosigna. You might be asked if details of your testing and treatment can be collected as evidence. You can ask your healthcare professional how your information will be stored and used.
Is this test right for me?
Your healthcare professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns. Your family can be involved too, if you wish. Read more about making decisions about your care.
Questions to think about
- How well does it work compared with other tests?
- What are the risks or side effects? How likely are they?
- What happens if I do not want to have a test?
- Can I choose where to have this test? Can I have this test at my local clinic or hospital?
- How long will it take to get the results?
- How do I get my test results? Will there be a follow-up appointment?
Information and support
The NHS webpages on breast cancer in women and breast cancer in men may be a good place to find out more.
Breast Cancer Now (0808 800 6000) can give you advice and support.
You can also get support from your local Healthwatch.
NICE is not responsible for the quality or accuracy of any information or advice provided by these organisations.
ISBN: 978-1-4731-6119-1
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