Richard Bender, MD
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The management of breast cancer has undergone an evolution in the past few years based on improved methods of early detection and increased public awareness. As such, almost 50% of all new diagnoses are for smaller, node negative primary cancers, the majority of which are ERA +'ve and HER2 negative. The decision as to whether these patients would benefit from chemotherapy, in addition to hormonal blockade, is based on tumor size, tumor grade, patient age and the judgment of the treating physician and patient. Newer genomic testing has added another level of scrutiny to this decision and allows the clinician to use the tumor's genomic profile to predict its biologic behavior and likelihood of recurrence. Recently, ASCO has acknowledged the importance of this testing by including such testing in its new guidelines for the management of early stage breast cancer. This presentation will review the currently available predictive and prognostic commercial assays and discuss their individual strengths and weaknesses, as well as plans for the future.