This specialist Guidelines summary provides recommendations on tumour profiling tests to guide adjuvant chemotherapy decisions for people with early breast cancer. The tests are EndoPredict (EPclin score), Oncotype DX Breast Recurrence Score, Prosigna, MammaPrint, and IHC4+C.
This summary is intended for use in a secondary care setting by oncologists. Please refer to the full guideline for further information.
Tumour Profiling Tests
- EndoPredict (EPclin score), Oncotype DX Breast Recurrence Score and Prosigna are recommended as options for guiding adjuvant chemotherapy decisions for people with oestrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative and lymph node (LN)-negative (including micrometastatic disease) early breast cancer, only if:
- they have an intermediate risk of distant recurrence using a validated tool such as PREDICT or the Nottingham Prognostic Index
- information provided by the test would help them choose, with their clinician, whether or not to have adjuvant chemotherapy taking into account their preference
- the companies provide the tests to the NHS with the discounts agreed in the access proposals, and
- clinicians and companies make timely, complete and linkable record-level test data available to the National Cancer Registration and Analysis Service as described in the data collection arrangements agreed with NICE
- MammaPrint is not recommended for guiding adjuvant chemotherapy decisions for people with ER-positive, HER2‑negative and LN-negative early breast cancer because it is not cost effective
- IHC4+C is not recommended for guiding adjuvant chemotherapy decisions for people with ER-positive, HER2-negative and LN‑negative early breast cancer because the analytical validity of the test is uncertain.