Early-Stage Breast Cancer: Selecting Genomic Assays in Clinical Practice

Dr. Sonya Reid and Dr. Allison DiPasquale discuss factors that influence the selection and application of genomic assays in the management of early-stage HR-positive, HER2-negative breast cancer. Dr. DiPasquale explains that assay selection is guided by the clinical scenario, the timing of testing, and how the results will inform patient management. She describes situations in which preoperative genomic testing may provide useful information for surgical planning and patient counseling, while emphasizing that biopsy-based results should be interpreted in the context of final surgical pathology and may require additional genomic evaluation following surgery. The discussion also highlights the importance of multidisciplinary collaboration, with the surgical oncologist and medical oncologist working together to determine whether further genomic testing is warranted to support adjuvant treatment decisions. Throughout the conversation, the faculty emphasize that genomic assay results should complement clinical judgment and other pathologic findings to support individualized, evidence-based care for patients with early-stage breast cancer.