This MammaPrint technology is capable of predicting the risk of recurrence of breast cancer, in patients with node negative, stage I and II invasive breast cancer whose tumors are 5cm or less in size regardless of the hormone receptor and menopausal status. This FDA approved test uses microarray analysis and looks at 70 critical genes capable of predicting prognosis and classifies patients into low risk (10% chance of recurrence in 10 years without any adjuvant therapy) or high risk (29% chance of recurrence in 10 years without any adjuvant therapy). It can further subclassify breast cancer using molecular subtyping into Luminal type, Basal type and ERBB2 (HER-2) subtypes.
This technology differs from Oncotype DX assay in that fresh tissue specimen is required for testing, hormone receptor status and menopausal state are not relevant and patients are classified into low risk and high risk categories without an intermediate risk group. Decisive treatment recommendations can therefore be made.
This testing methodology has been extensively validated and will help us decide who would and who would not benefit from chemotherapy. With the ability to sub type breast cancer based on molecular profiling and the benefits demonstrated with PARP (Poly (ADP-ribose) polymerase inhibitors in the triple negative (Basal type) breast cancer patients, the era of personalized medicine is welcome news for patients with breast cancer. There is also promising data demonstrating the benefit of this test in predicting disease outcome in patients with 1-3 positive lymph nodes as well as its ability to predict response following neoadjuvant chemotherapy in breast cancer.