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Genomic Testing to Guide Local Therapy Decisions in Hormone Receptor-Positive Breast Cancer

  • Review
  • Published:
Current Breast Cancer Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To explore how genomic testing has changed local therapy decision-making, specifically surgical timing and opportunities for de-escalation of radiation therapy in hormone receptor-positive, HER2-negative (HR + HER2-) breast cancer.

Recent Findings

Randomized trials have shown that genomic tests can be used to guide systemic therapy decision in HR + HER2- breast cancer, with a significant proportion of patients not receiving benefit from chemotherapy. Emerging data suggests that the use of genomic testing on core needle biopsy can also predict response to preoperative therapy and guide choices between neoadjuvant treatments when preoperative therapy is needed, especially in women with limited nodal disease that may not otherwise require chemotherapy. Further, genomic tests can stratify which patients are at the lowest risk for locoregional recurrence and may be candidates for omission of radiation therapy.

Summary

Genomic testing can guide surgical timing and opportunities for selecting the lowest-risk patients for omission of radiation therapy.

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Author information

Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

    Kate Lloyd

  2. Division of Breast Surgery, Department of Surgery, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02215, USA

    Olga Kantor

  3. Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA

    Olga Kantor

  4. Harvard Medical School, Boston, MA, USA

    Olga Kantor

Authors
  1. Kate Lloyd
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  2. Olga Kantor
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Both authors drafted the work and revised it critically, were involved in the concept and design as well as analysis of the data.

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Correspondence to Olga Kantor.

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Lloyd, K., Kantor, O. Genomic Testing to Guide Local Therapy Decisions in Hormone Receptor-Positive Breast Cancer. Curr Breast Cancer Rep (2024). https://doi.org/10.1007/s12609-024-00538-1

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