Early-Stage Breast Cancer: Evolution of Genomic Testing

Dr. Sonya Reid introduces the program by outlining the objectives of the discussion, which focus on the expanding role of genomic testing in the management of early-stage HR-positive, HER2-negative breast cancer. She highlights the importance of integrating multigene assays with traditional clinicopathologic factors to refine risk assessment, individualize treatment decisions, and guide the use of adjuvant therapy. Dr. Allison DiPasquale then reflects on the evolution of treatment decision-making, explaining that historical approaches relied primarily on tumor size and receptor status, often resulting in broader use of chemotherapy. She discusses how genomic assays have transformed early-stage breast cancer care by providing a deeper understanding of tumor biology, enabling more personalized treatment strategies rather than relying solely on conventional clinical features. Using the analogy of a "wolf in sheep's clothing," Dr. DiPasquale emphasizes that genomic testing can identify biologically aggressive tumors that may otherwise appear clinically low risk, supporting more individualized, evidence-based patient care.