Multidisciplinary approach to genomic testing decisions in early-stage breast cancer
Timing considerations for test ordering (presurgical core biopsy vs postsurgical specimen)
Communication approaches with patients regarding testing and results
Key Points for Physicians:
Genomic testing decisions benefit from multidisciplinary tumor board input involving surgeons, medical oncologists, and pathologists.
Testing on core biopsy specimens can reduce the time to treatment decisions by 2 to 3 weeks.
Testing may be unnecessary if a patient has comorbidities precluding chemotherapy or has already declined chemotherapy.
Notable Insights:
Surgeons often order the genomic tests, but medical oncologists typically use the information to guide treatment decisions.
Reducing time between diagnosis and treatment plan development addresses patients’ key concerns: “Why did I get this?” and “Will I need chemotherapy?”
Clinical Significance: Effective implementation of genomic testing requires thoughtful coordination between surgical and medical oncology teams, with consideration for patient preferences, and timing that can significantly improve the treatment planning process..