Emerging Treatment Approaches for HR+/HER2– Early-Stage Breast Cancer - Episode 2

Approaches to eBC Diagnosis and Risk Stratification

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Panelists discuss how the NCCN guidelines for risk stratification in HR+/HER2– early-stage breast cancer (eBC) guide clinical decision-making, exploring real-world adherence to these guidelines, the complexity of risk stratification in various clinical scenarios, and the role of clinical factors, biomarkers, and advanced testing methodologies (including RSClin N+, next-generation sequencing [NGS], fluorescence in situ hybridization [FISH], immunohistochemistry [IHC], and circulating DNA [ctDNA]) in defining “high-risk” patients and guiding treatment strategies.

Video content above is prompted by the following:

  • What are the key NCCN guidelines for risk-stratifying patients with HR+/HER2–eBC?
    • How closely does overall real-world practice follow these guidelines?
    • What clinical scenarios make risk stratification complex?
  • Can you please describe your approach to diagnosing and stratifying HR+/HER2– breast cancer at an early stage?
    • How do you define “high-risk” in this setting?
    • How do clinical factors play a role in risk stratification?
    • When and how do you evaluate nodal involvement in patients with breast cancer?
    • What biomarkers do you typically test for in eBC? (HR, PR, HER2, others?)
    • What testing methodologies are most used?
      • How do they differ, and what can you learn from each? (NGS, FISH, IHC, panels, etc)
      • Do you ever check ctDNA?
    • How do various testing results guide your treatment approach?