Table 2.

Genomic risk assessment tools.

Tool	Description	Level of Evidence
COMBINED GENOMIC/CLINICAL
EndoPredict (23–25),	RNA based, 12-gene assay combined with tumor size and nodal status, developed in pre- and post-menopausal women treated with tamoxifen	- Validated ~2600 post-menopausal women in ABCSG6/8 and TransATAC
Prosigna ROR (26–28),	PAM50-based 46 gene-signature developed in pre- and post-menopausal women treated withoutany adjuvant systemic therapy. Includes tumor size	- Validated in ~2100 women in ABCSG 8 and TransATAC and in ~2500 Danish women cohort for 10-year risk of recurrence
GENOMIC
Breast Cancer Index (29, 30),	Combines the 2-gene HOXB13:IL17BR ratio with the molecular grade index from five proliferation genes in a linear model; developed in post-menopausal patients with HR-positive, node negative breast cancer. The node positive assay includes tumor size	- Developed on blinded retrospective analysis of 588 Swedish women treated on tamoxifen trial
MammaPrint (31, 32),	70-gene RNA expression profile	- Level 1 evidence for addition of systemic chemotherapy to adjuvant anti-estrogen therapy
Recurrence Score (OncotypeDx) (33)	21-gene signature developed in HR-positive, N0 patients. RxPONDER demonstrated discrimination extends to post-menopausal women with disease involvement in 1-3 nodes	- Designed to predict benefit of addition of systemic chemotherapy to adjuvant anti-estrogen therapy; Level 1 evidence for this