Studies extracted from the basic literature search were analysed. Data from eight studies {1; 2; 3; 4; 5; 7; 8; 9} were found to be relevant to this question. The ORG and TEC domains also provided information relevant to this question.

Taking into account the outcomes described in the scope, the resources to be included in the analysis extend beyond those used in the diagnostic process.

Depending on the patient’s risk of recurrence, early invasive breast cancer may be treated, after primary surgery, with adjuvant chemotherapy to prevent or delay distant recurrence {1; 2}. The introduction of prognostic tests that assess the likelihood of breast cancer recurrence {TEC domain} could change the probability of using adjuvant chemotherapy to treat invasive breast cancer. Thus the use of prognostic tests will change the costs associated with treatment and the downstream costs of dealing with any cancer recurrences. It is important to include all the resources used and their costs. The resources used were identified from four main studies {2; 3; 4; 5}.

According to Chen et al. {6} after patients are divided according to risk profiles, they can be assigned to different treatment scenarios: chemotherapy plus endocrine therapy for oestrogen (ER)-positive, high-risk patients; chemotherapy alone for ER-negative, high-risk patients; endocrine therapy alone for ER-positive, low-risk patients; and no adjuvant therapy for ER-negative, low-risk patients. Anti-HER2 (human epidermal growth factor receptor 2) agents (e.g trastuzumab) can be added to chemotherapy depending on the risk classification and HER2 status {3}.

Table 1. Resources identified