Early-Stage Breast Cancer: Integrating Genomic and Clinicopathologic Risk Factors

Dr. Sonya Reid and Dr. Allison DiPasquale discuss how treatment planning for early-stage HR-positive, HER2-negative breast cancer extends beyond genomic assay results alone by integrating clinicopathologic features and patient-specific factors. Dr. DiPasquale explains that age, menopausal status, tumor size, nodal involvement, hormone receptor expression, HER2 status, and Ki-67 are all considered alongside genomic testing to provide a comprehensive assessment of recurrence risk and guide individualized treatment recommendations. She emphasizes the value of multidisciplinary collaboration between surgical and medical oncology when determining the optimal treatment sequence, particularly in more complex clinical scenarios. Dr. Reid describes her approach to ordering genomic assays following surgery and notes that institutional workflows may influence when testing is performed, while emphasizing that both preoperative and postoperative strategies can support effective care. The faculty conclude that combining clinical judgment with genomic information enables more personalized, evidence-based decision-making and supports individualized management for patients with early-stage breast cancer.