Dr. Pusztai Discusses BCI in Patients With ER-Positive/HR-Positive Breast Cancer

Lajos Pusztai, MD, DPhil, professor of Medicine (Medical Oncology), chief, Breast Medical Oncology, co-director, Cancer Genetics Research Program, Yale Cancer Center, discusses the Breast Cancer Index (BCI) in patients with ER-positive/HR-positive breast cancer.

Tumor size and nodal status are not accurate predictors of which patients are at high risk for disease recurrence after five years from initial therapy, Pusztai explains. Prediction tools such as Adjuvant Online and the Recurrence Score assay make predictions over a 10-year period, but do not separate risks for early- or late recurrence.

The BCI is a molecular assay that was designed to help with this decision-making dilemma, Pusztai adds. This tool has led researchers to believe that ER-positive patients with a high proliferation index will benefit from extended endocrine therapy. Three randomized trials demonstrated that the assay does help identify patients at high risk for late recurrence. The MA.17 trial, for example, also showed that extended endocrine therapy in these patients demonstrates an improvement in recurrence-free survival.