Early-Stage Breast Cancer: Guideline-Directed Use of Genomic Testing

Dr. Sonya Reid and Dr. Allison DiPasquale discuss how clinical practice guidelines have influenced the use of genomic testing in the management of early-stage HR-positive, HER2-negative breast cancer. Dr. DiPasquale describes her approach to incorporating genomic assays early in the treatment pathway for appropriate patients, emphasizing their value in identifying tumors with higher-risk biological features that may not be fully reflected by conventional clinicopathologic characteristics alone. She also highlights the importance of selecting patients for testing when results are likely to influence treatment recommendations. From the medical oncology perspective, Dr. Reid explains how she applies guideline recommendations in routine practice, noting that genomic testing is commonly used following surgery for eligible patients to guide discussions regarding the potential benefit of adjuvant chemotherapy. She also acknowledges that clinical judgment remains important in selected lower-risk cases, reinforcing that treatment decisions in early-stage breast cancer are individualized by integrating guideline recommendations with patient- and tumor-specific factors.