Dr Diab on the Value of the Breast Cancer Index for Assessing Disease Recurrence Risk

“Between years 0 and 5 [following breast cancer diagnosis], it’s also important to [consider] the risk of recurrence when we’re offering hormonal therapy, because patients between 0 and 5 [years from diagnosis] have several options for hormonal therapy.”

Sami Diab, MD, medical director of the Center for Cancer and Blood Research at the Pagosa Springs Medical Center, discussed the clinical utility and prognostic significance of the Breast Cancer Index (BCI) in patients with breast cancer receiving adjuvant endocrine therapy.

Diab emphasized the dual role of the BCI for identifying both early and late recurrence risks in this patient population. Although the BCI test is frequently associated with decision-making for extended adjuvant therapy—specifically the window between 5 and 10 years post-diagnosis—Diab clarified that the assay is also validated as a prognostic tool for early recurrence, covering the initial 0-to-5-year interval. Consequently, the BCI provides comprehensive prognostic insights across a full 10-year trajectory, allowing oncologists to better understand a patient’s individualized risk of disease recurrence from the moment of diagnosis, he stated.

Diab highlighted that although the test’s predictive value is most often used to determine the benefit of continuing endocrine therapy beyond 5 years, assessing the risk of disease recurrence within the first 5 years of breast cancer diagnosis is essential when offering primary hormonal therapy. During this early treatment phase, Diab said that oncologists must choose between various systemic therapy options, such as aromatase inhibitors or tamoxifen (Nolvadex). For premenopausal patients specifically, he explained that a major clinical challenge involves the decision of whether to incorporate ovarian suppression into the regimen. Diab noted that this area of breast cancer management remains one where more data are required to assist oncologists in making informed, evidence-based treatment decisions. By leveraging the BCI’s prognostic capabilities for both early and late recurrence, oncologists can more effectively tailor endocrine therapy strategies to the risk profiles of each patient, he concluded.