Br J Cancer: Multigene testing guides chemotherapy recommendations for breast cancer

Breast cancer is the most commonly diagnosed cancer in women.
in the EU, including the UK, 404,920 women were diagnosed with breast cancer in 2018, of which 98,755 died.
Among them, breast cancer patients who are positive for hormones (HoR) (i.e. ER (estrogen) positive and/or PR (progesterone liber) positive) and HER2 (human skin growth factors are positive) account for about 70% of breast cancer diagnosed in Western countries.
at the time of diagnosis, about 60 per cent of cancer types had not yet spread to the lymph nodes, and about 15 per cent of these patients would relapse within 10 years if only assisted endocrine therapy was received.
, predicting the risk of recurrence and response to chemotherapy in patients with early breast cancer is critical to optimizing the rate of complementary treatment.
Therefore, the study aims to develop health care recommendations on whether the use of multigene testing can guide the development of complementary chemotherapy in patients with early-stage immersive breast cancer, hormone-positive, HER2-negative patients.
The European Commission Breast Cancer Initiative (ECIBC) aims to provide evidence-based recommendations for breast cancer screening and diagnosis, and the ECIBC Guidelines Development Group (GDG) prioritizes the use of multigene testing for clinical issues to guide complementary chemotherapy in patients with HoR-positive, HER2-negative and lymph node-negative, or up to three lymph node-positive leaching breast cancers.
21-RS and 70-GS-related process diagrams evaluated four multigene tests in the study: 21 gene recurrence score (21-RS), 70 gene characteristic score (70-GS), 50 gene recurrence risk score (PAM50-RORS), and 12 gene molecular score (12-MS).
results showed that in five studies (two randomized controlled studies for genetic testing, two randomized controlled studies for secondary analysis, and one summary analysis from observational studies), no qualified studies consistent with PAM50-RORS or 12-MS were identified, and GDG did not recommend these tests.
Therefore, ECIBC GDG recommends 21-RS testing for women with negative lymph nodes (conditional recommendation, very low evidence certainty) and, depending on clinical characteristics, may benefit more from women at higher risk of recurrence.
70-GS test is recommended for women with high clinical risk (conditional recommendation, low evidence certainty) and 70-GS testing is not recommended for women with low clinical risk (strong recommendation and low evidence certainty).