Molecular Profiling; From prognosis to prediction – remaining questions

Highlights

• 1

  There is robust evidence for predictive value using gene expression profiles to direct chemotherapy choices in the neo-adjuvant and adjuvant setting

• 2

  The use of prognostic signatures to predict chemotherapy benefit means that many of the existing challenges of these prognostic signatures will also impact on predictive use.

• 3

  Gaps in evidence exist particularly for pre-menopausal women with ovarian suppression and clinically very high risk (pN2 patients)

• 4

  Discrepancies in test results at the individual patient level give rise for concern.

• 5

  The impact of other variables is uncertain at present (e.g. Lobular cancers, Male breast cancer, ethnicity)