BREAST CANCER INDEX: New Tool to Help Guide Cancer Therapy

By Kim Maxfield RN, CCRC - Clinical Research Nurse

Having the diagnosis of breast cancer is scary and the treatment benefit for long term endocrine therapy after 5 years is still uncertain. Patients with ER+ breast cancer usually have a good prognosis; however, the risk of the cancer recurring before and after 5 years is similar.

How long does a patient need to be on anti-estrogen therapy?
Initially, it was thought that 5 years was adequate. Recent studies have shown that for some women, an additional 5 years of anti-estrogen therapy is beneficial. For women who were recurrence free at 5 years, only about 3- 5% benefited from an additional 5 years of treatment.

It is also important to weigh the benefits of continuing treatment to the potential risks and side effects.
Some reported side effects of anti-estrogen therapy are:
Long term safety concerns: Endometrial cancer, osteoporosis, cataracts, bone fractures, blood clots and heart disease.
Day to day tolerability issues: Vaginal dryness, itchiness and discharge, hot flashes or night sweats, joint stiffness or pain, muscle pain and sexual dysfunction.

The Breast Cancer Index test, made by BioTheranostics can help to answer some of these questions. The Breast Cancer Index uses tissue from the original Breast Cancer surgery and analyzes seven genes that can influence how likely the cancer is to come back 5 to 10 years after diagnosis, as well as how likely a woman is to benefit from an additional 5 years of treatment.

The Breast Cancer Index result has two scores. The first score predicts the risk of the cancer coming back beyond 5 years (years 5-10). Scores range from 0-10. Cancers with scores of 0-5 are classified as having low risk of late recurrence. Cancers with scores of 5.1-10 are classified as having a high risk of late recurrence.

The second score predicts the likelihood of benefit from an additional 5 years of anti-estrogen therapy.
The results are reported as low likelihood of benefit or high likelihood of benefit.

Who is eligible for the breast cancer index?
• Patients that were diagnosed with early stage (stage I-III) breast cancer
• The cancer was hormone-receptor positive and HER2-negative 
• There was no cancer in the lymph nodes (lymph node-negative disease)
• Patients that have been taking hormonal therapy for 4-5 years and want to know if taking hormonal therapy for more time will be beneficial

The BCI offers a validated predictive tool that women along with their physician can use to decide treatment strategies that is right for them. The test is currently not approved by the US Food and Drug Administration. Medicare covers the BCI at a predetermined rate with no fees charged to the patient as long as the eligibility criteria are met. Many commercial insurance companies also reimburse for the BCI but be sure that you or your physician’s office checks for coverage before ordering the test.

BioTheranostics (the company that makes the test) does have a patient advocate team to help with verifying insurance coverage and obtaining reimbursement. They also have a patient assistance program that helps to pay for testing.

​To contact the patient advocate team you can call 877-886-6739 or patientadvocates@biotheranostics.com. There are new treatments and tools being studied all the time for breast cancer patients. The Breast Cancer Index is one of the new tools being used to help with long term treatment decisions and is being reimbursed by more insurance companies daily. For patients that are interested in more information or would like to have the test done, please talk to you oncologist to see if you qualify and if your insurance will cover the test. 

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