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Updates to NCCN Guidelines on Molecular Assays for Patients With Breast Cancer

William J. Gradishar, MD
Published Online:2:47 PM, Mon April 8, 2019

William J. Gradishar, MD, chief of hematology and oncology, department of medicine, Betsy Bramsen Professorship of Breast Oncology, professor of medicine (hematology and oncology), Northwestern University's Feinberg School of Medicine, discusses the NCCN guidelines in regard to selecting molecular assays for patients with breast cancer. Currently, there are 3 available assays that clinicians can order: 21-gene, 50-gene, and 70-gene assays.

The panel has been most impressed to date with the 21-gene, but there has been equal level 1 support for the 70-gene, says Gradishar. The guidelines have put together a table over the last year listing all the molecular assays currently available and the level of support each provides. This isn’t meant to make the decision for clinicians, but simply provide evidence for them.

Gradishar says physicians are challenged to best implement these tests in their practice and determine in what cases they should be used. The NCCN does not recommend using more than 1 assay in a patient as it can often lead to confusion. However, this may be a new way of refining how recommendations are made for individual patients.
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