Should Gene-Expression Profiles Be Routinely Used OR Are Standard Prognostic Factors Adequate?
Gene-expression profiling has transformed the way breast cancer is viewed. It has confirmed the heterogeneity of breast cancer and revealed molecular signatures that could influence clinical care. Large prospective studies are being conducted to compare genomic testing and traditional clinical factors in making treatment decisions. The following are highlights from the discussion: • Apart from being a prognostic indicator, certain genomic signatures—such as the 21-gene recurrence score assay (Oncotype DX®)—demonstrated that they also may have predictive benefits, such as the ability to identify patients that may not benefit from chemotherapy. • Gene expression profiles probably should not be ordered in a patient that is going to receive chemotherapy anyway; however, they could be valuable in cases where the pathology report is unclear or unreliable. • The cost of gene expression profiles is an issue for many clinicians and payors. A panel member noted, however, that if the cost of chem
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