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Opinion|Videos|December 12, 2024

Approaches to eBC Diagnosis and Risk Stratification

Author(s)Kevin Kalinsky, MD, MS, Virginia Kaklamani, MD

Panelists discuss how the NCCN guidelines for risk stratification in HR+/HER2– early-stage breast cancer (eBC) guide clinical decision-making, exploring real-world adherence to these guidelines, the complexity of risk stratification in various clinical scenarios, and the role of clinical factors, biomarkers, and advanced testing methodologies (including RSClin N+, next-generation sequencing [NGS], fluorescence in situ hybridization [FISH], immunohistochemistry [IHC], and circulating DNA [ctDNA]) in defining “high-risk” patients and guiding treatment strategies.

Episodes in this series

EP. 1 Introduction and HR+/HER2– eBC Overview

EP. 1 Introduction and HR+/HER2– eBC Overview

EP. 2 Approaches to eBC Diagnosis and Risk Stratification

EP. 2 Approaches to eBC Diagnosis and Risk Stratification

EP. 3 CDK4/6 Inhibitors Treatment Options in the eBC Setting

EP. 3 CDK4/6 Inhibitors Treatment Options in the eBC Setting

EP. 4 Clinical Trial Considerations for eBC Treatment Selection

EP. 4 Clinical Trial Considerations for eBC Treatment Selection

EP. 5 Clinical Decision-Making for a Patient With eBC: Scenario and Strategies

EP. 5 Clinical Decision-Making for a Patient With eBC: Scenario and Strategies

EP. 6 Managing CDK4/6 Inhibitor Toxicities and Encouraging Adherence

EP. 6 Managing CDK4/6 Inhibitor Toxicities and Encouraging Adherence

EP. 7 Multidisciplinary Treatment Sequencing and Coordination

EP. 7 Multidisciplinary Treatment Sequencing and Coordination

EP. 8 Summary of Recent Advances and Unmet Needs for Patients With eBC

EP. 8 Summary of Recent Advances and Unmet Needs for Patients With eBC

Video content above is prompted by the following:

What are the key NCCN guidelines for risk-stratifying patients with HR+/HER2–eBC?
- How closely does overall real-world practice follow these guidelines?
- What clinical scenarios make risk stratification complex?
Can you please describe your approach to diagnosing and stratifying HR+/HER2– breast cancer at an early stage?
- How do you define “high-risk” in this setting?
- How do clinical factors play a role in risk stratification?
- When and how do you evaluate nodal involvement in patients with breast cancer?
- What biomarkers do you typically test for in eBC? (HR, PR, HER2, others?)
- What testing methodologies are most used?
  - How do they differ, and what can you learn from each? (NGS, FISH, IHC, panels, etc)
  - Do you ever check ctDNA?
- How do various testing results guide your treatment approach?

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