Published online Dec 10, 2014. doi: 10.5306/wjco.v5.i5.795
Revised: August 19, 2014
Accepted: September 16, 2014
Published online: December 10, 2014
Breast cancer remains a major cause of neoplastic disease in much of the developed world. The majority of cases are diagnosed with oestrogen receptor (ER)-positive and human epidermal growth factor receptor-2 negative invasive ductal carcinoma and are treated predominantly by surgery which includes sentinel node biopsy and adjuvant endocrine therapy ± adjuvant radiotherapy. It is believed that an indeterminate subset of the patient population is needlessly incurring chemotherapy related morbidity without attaining any increase in survival due to therapy. Furthermore in the era of extended adjuvant endocrine therapy it is important to identify those patients who can be safely treated with 5 years rather than 10 years of endocrine therapy thus optimising the benefit-risk balance. This perception has propelled the development of more personalised prognostic tools for newly diagnosed cases of ER-positive breast cancer. In this article, we shall review the evidence regarding the currently available gene assays for human breast cancer.
Core tip: Recurrence score, Prosigna and EndoPredict (EP) currently have the most convincing evidence available, of which Prosigna and EP have a significant degree of external validation. In terms of cost and turnover, EP has an advantage over its competitors, being designed to be performed at a local laboratory rather than at a central facility. The results of the MINDACT and TailoRx trials are awaited.