Genomic Testing in Breast Cancer: A Predictive and Prognostic Tool in an Evolving Landscape

Introduction and Historical Context

Main Discussion Topics:

• Focus of discussion: Role of genomic testing in breast cancer as a predictive and prognostic tool for treatment decisions
• Historical context of breast cancer treatment, contrasting the 1990s’ approach (when all women with node-negative breast cancer received chemotherapy) with current personalized approaches

Key Points for Physicians:

• Genomic profiling has transformed treatment decision-making by helping identify which patients would benefit from chemotherapy, endocrine therapy, or both.
• In the 1990s, all women with 1-cm or greater node-negative breast cancer received chemotherapy despite only 4% to 6% benefiting.
• Genomic testing allows for more personalized and targeted treatment approaches.

Notable Insights:

• The evolution from treating all patients with similar disease characteristics the same way to the current personalized medicine approach represents a significant advancement in breast cancer care.

Clinical Significance: Genomic testing has revolutionized breast cancer treatment by enabling physicians to move away from a “one-size-fits-all” approach to a more targeted strategy that spares many patients from unnecessary chemotherapy while identifying those who truly benefit.