Gene Assays and the Treatment of Breast Cancer

Kathy S. Albain, MD, medical oncologist, Loyola University Chicago, professor, Stritch School of Medicine, director, Breast Clinical Research Program, Thoracic Oncology Research Program, Cardinal Bernardin Cancer Center, discusses gene assays as they relate to the treatment of patients with breast cancer.

In her presentation at the 12th International Congress on the Future of Breast Cancer from July 18-20, 2013, in Huntington Beach, CA, Albain first discussed the fact that a certain population of patients with large numbers of positive nodes or large tumors can be cured with surgery. Research is being conducted to find these patients, as well as those who have small tumors with a high propensity for metastases. All of the research to date has further demonstrated the necessity for a combination tool that can incorporate many patient factors.

Clinical Pearls

A 21-gene (Oncotype DX) assay only helps the decision-making process, Albain says. However, Albain does not order a 21-gene assay in all patients, especially those who are sure about how they want to be treated or if urgent treatment is necessary. Often times, clinical factors and biologic factors are discordant, Albain says, reinforcing the need for additional research.

• There is a population of patients with breast cancer who can be cured with just surgery
• Research is being conducted to find patients with small tumors that have a high propensity for metastases
• A 21-gene (Oncotype DX) assay can help in the decision-making process, though Albain says she does not order it in every patient