Calculation of Risk
Two tests currently are FDA approved to analyze specific genes in breast tumors that confer favorable or unfavorable prognosis. Results of these tests can be used to provide information on risk of recurrence and assist with treatment decisions.
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Oncotype DX® (Genomic Health, Inc., Redwood City, CA) is performed on formalin-fixed, paraffin-embedded tumor tissue to analyze the expression of a panel of 21 genes. The results are given as a Recurrence Score™ (0–100).
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MammaPrint® (Agendia, Amsterdam, Netherlands) gene expression profiling is performed on unfixed tissue, which is sampled and placed in a preservative solution for testing. The MammaPrint® test analyzes 70 genes and provides a recurrence risk score.
Case Study 1
Mrs. S is a Caucasian Protestant female who is 46 years old without a history of cancer. She works as an elementary school teacher. She presents for cancer risk assessment. Her weight is 155 pounds, and her height is 5 feet, 10 inches. She reports that she eats four to five servings of vegetables per day and has about one alcoholic beverage daily. She began her menses at age 12 and had her first live birth at age 28. She has not breastfed. She is a Gravida 3, Para 3 and not on birth control. She currently has regular menstrual cycles. She has had two breast biopsies in the past, one that showed a fibroadenoma and one that showed atypical hyperplasia. Her two sisters are both healthy; neither has a diagnosis of breast cancer. Her mother is alive at age 71 but was diagnosed with breast cancer at age 39.
Go to the following two sites and calculate Mrs. S’s risk for developing breast cancer.
Case Study 2
The Mid-Atlantic Cancer Genetics Network presents the case of Jane, a 36-year-old white non-Jewish woman who came in because she was concerned about her risk for developing breast cancer. Read the complete case study.