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TOPLINE:

The Breast Cancer Index (BCI) test assay could help physicians alter their extended endocrine therapy recommendations for patients with hormone receptor (HR)–positive breast cancer and reduce the risk for both over- and undertreatment.

METHODOLOGY:

• The BCI Registry evaluates the long-term outcomes, decision impact, and medication adherence in patients receiving BCI testing as part of routine clinical care.
• Women diagnosed with stages I-III HR-positive breast cancer who had completed 4-7 years of primary adjuvant endocrine therapy and remained recurrence-free were eligible to participate.
• All participants were required to have an available pretreatment tumor specimen and to have undergone BCI gene expression analysis.
• Both physicians (843) and patients (823) completed pre-BCI and post-BCI decision-impact questionnaires, assessing physician confidence in their decision-making and patient concerns and comfort levels.
• The mean patient age at enrollment was 65 years, and 88.4% were postmenopausal. Tumor analysis revealed that 74.7% were stage T1, 53.4% were grade 2, 76.0% were node-negative, and 13.8% were human epidermal growth factor receptor 2–positive.

TAKEAWAY:

• Out of the 1073 patients who had BCI results reported, 658 (61.3%) were classified as having a low likelihood of benefiting from extended endocrine therapy based on their BCI score, while 415 (38.7%) were classified as having a high likelihood of benefiting from extended endocrine therapy based on their BCI score.
• Physicians changed their extended endocrine therapy recommendations in 40.1% of cases following BCI testing, while 45.1% of patients changed their preferences (P < .0001 vs pretest questionnaires).
• Moreover, 38.8% of physicians felt more confident in their recommendation following BCI testing, and 41.4% of patients felt more comfortable with their extended endocrine therapy decision (P < .0001 for both).
• Between the pretest and posttest questionnaires, patients became less concerned about the cost, drug safety, and benefits of extended endocrine therapy.

IN PRACTICE:

"The Breast Cancer Index helps us prevent over- and undertreatment for extended antiestrogen therapy and is an incredibly helpful tool, giving us more confidence in our treatment decisions for breast cancer patients," said lead researcher Tara B. Sanft, MD, Survivorship Clinic, Yale School of Medicine, New Haven, Connecticut, in a release.

SOURCE:

The research, led by Tara B. Sanft, MD, Survivorship Clinic, Yale School of Medicine, New Haven, Connecticut, was published earlier this month in the Journal of the National Comprehensive Cancer Network.

LIMITATIONS:

The authors noted that the study may be limited by the questionnaires being self-reported, potentially leading to the misreporting of information. In addition, some questionnaire data were missing, which could bias the estimates.

DISCLOSURES:

The study was funded by Hologic, Inc., and its subsidiary, Biotheranostics, Inc. Sanft declared no relevant financial relationships. Other authors declared numerous financial relationships, including AstraZeneca, Daiichi Sankyo, Eisai, GI Therapeutics, Genentech, Eli Lilly and Company, Novartis, Ontada, Pfizer Inc., and Roche.