How is the disease/health condition currently being diagnosed?
Authors: Sarah Baggaley, Massimo Gion
Internal reviewers: Luciana Ballini, Aurora Llanos, Antonio Migliore, Claudia Wild
The information used for this section was from the responses received from the multiple choice survey that was sent to European healthcare agencies.
Information received from European healthcare agencies reported current clinical practice for assessing the risk of breast cancer recurrence. Ten healthcare agencies responded and described the type of information that is used:
Age of patient, tumour size, lymph node status.
Clinical observations (e.g. age, menopausal status), pathological (tumour size, tumour grade) and molecular (ER, HER2) parameters. Oncotype DX used for lymph node-negative, ER+, early-stage breast cancer.
Results of histological examinations (G, ER, PR, HER, Ki67, parameters of lympho-vascular invasion).
TNM classification, immunohistochemistry tests, age and general condition of patient are the most used parameters to assess breast cancer recurrence.
A range of guidelines are used. Most often, local guidance, based on the Nottingham Prognostic Index and on Adjuvant! Online, has been developed to help clinicians understand the risk of breast cancer recurrence and to decide the benefits of adjuvant therapy for a particular patient.
Accurate classification of primary lesions, familiarity, genetic profile.
The risk of breast cancer is assessed with pathohistology (size of tumour, nodal status, tumour grade, lymphovascular invasion) oestrogen and progesterone receptors, HER2 status (both Herceptest and FISH), and MIB1(ki-67). In some cases of luminal B tumours, additional tests are used.
Each institution (hospital) has its own methods of assessing risk of breast cancer recurrence.
Baggaley S, Gion M Result Card CUR22 In: Baggaley S, Gion M Health Problem and Current Use of the Technology In: Jefferson T, Vicari N, Raatz H [eds.]. Prognostic tests for breast cancer recurrence (uPA/PAI-1 [FEMTELLE], MammaPrint, Oncotype DX ) [Core HTA], Agenzia nationale per i servizi sanitari regionali (age.na.s), Italy ; 2013. [cited 3 December 2022]. Available from: http://corehta.info/ViewCover.aspx?id=113