Genomic Testing in Early-Stage Breast Cancer: Institutional and Multidisciplinary Perspectives

Approaches to Genomic Testing Implementation

Main Discussion Topics:

• Multidisciplinary approach to genomic testing decisions in early-stage breast cancer
• Timing considerations for test ordering (presurgical core biopsy vs postsurgical specimen)
• Communication approaches with patients regarding testing and results

Key Points for Physicians:

• Genomic testing decisions benefit from multidisciplinary tumor board input involving surgeons, medical oncologists, and pathologists.
• Testing on core biopsy specimens can reduce the time to treatment decisions by 2 to 3 weeks.
• Testing may be unnecessary if a patient has comorbidities precluding chemotherapy or has already declined chemotherapy.

Notable Insights:

• Surgeons often order the genomic tests, but medical oncologists typically use the information to guide treatment decisions.
• Reducing time between diagnosis and treatment plan development addresses patients’ key concerns: “Why did I get this?” and “Will I need chemotherapy?”

Clinical Significance: Effective implementation of genomic testing requires thoughtful coordination between surgical and medical oncology teams, with consideration for patient preferences, and timing that can significantly improve the treatment planning process..