TABLE 1.

Gene expression profiles to guide adjuvant therapy decisions in ER‐positive and HER2‐negative early breast cancer

Age/menopausal status	Lymph node status	Biomarkers	Recommendations [51]
Premenopausal or age ≤ 50 years	Node‐negative	Oncotype DX (21‐gene recurrence score, 21‐gene RS)	For patients with RS ≥26, chemotherapy and endocrine therapy should be offered. For those with RS 16∼25, chemotherapy and endocrine therapy may be offered.
	1‐3 positive nodes	Insufficient evidence to recommend	N/A
	≥4 positive nodes	Insufficient evidence to recommend	N/A
Postmenopausal or age > 50 years	Node‐negative	Oncotype DX	For patients with RS ≥26, chemotherapy and endocrine therapy should be offered.
		MammaPrint (70‐gene signature)	For patients with high clinical risk, MammaPrint test may be used to guide decisions for adjuvant endocrine and chemotherapy. For patients with low clinical risk, evidence is insufficient to recommend its routine use.
		EndoPredict (12‐gene risk score)	The clinician may use the EndoPredict test to guide decisions for adjuvant endocrine and chemotherapy.
		Prosigna (PAM50)	The clinician may use the Prosigna to guide decisions for adjuvant systemic chemotherapy.
		BCI	For patients treated with 5 years of primary endocrine therapy without evidence of recurrence, BCI may be offered to guide extended endocrine therapy decisions.
	1‐3 positive nodes	Oncotype DX	For patients with RS ≥26, chemotherapy and endocrine therapy should be offered.
		MammaPrint	For patients with high clinical risk, MammaPrint may be used to guide decisions for adjuvant endocrine and chemotherapy. For patients with low clinical risk, evidence is insufficient to recommend its routine use.
		EndoPredict	The clinician may use the EndoPredict test to guide decisions for adjuvant endocrine and chemotherapy.
		BCI	For patients treated with 5 years of primary endocrine therapy without evidence of recurrence, BCI may be offered to guide extended endocrine therapy decisions.
	≥4 positive nodes	Insufficient evidence to recommend	N/A

Abbreviations: RS, recurrence score; BCI, breast cancer index; N/A, not applicable.