Each case of breast cancer is different, so treatment shouldn't take a one-size-fits-all approach. The Breast Cancer Index (BCI) is a test that can help you get breast cancer care personalized to your unique tumor biology.
Clinicians use the BCI for early-stage hormone receptor-positive (HR+) breast cancer patients to determine the chances that their breast cancer will return somewhere else in their body within 10 years of diagnosis. The results from the BCI can be used to determine whether staying on treatments that block or lower estrogen (anti-estrogen therapy) is likely to reduce that risk.
Considering about 4 out of 5 cases of breast cancer are HR+, the BCI test is an important tool when deciding on a treatment plan for many women.
Recently, the BCI test options were expanded to help patients get more information to help personalize their treatment decisions earlier in their diagnosis.
Here’s what you need to know — and what’s new — about the BCI test.
What is the Breast Cancer Index test?
The BCI test analyzes the activity in 11 genes found in breast cancer tissue to assess how likely the cancer is to grow and spread as well as to determine if staying on anti-estrogen therapy for longer may help lower that risk.
The test is performed by evaluating the biology of a patient’s original tumor sample and uses tissue that was preserved during the original biopsy or breast surgery, so no additional procedures are needed.
Who should get a Breast Cancer Index test?
The BCI test is only for people who’ve been diagnosed with early-stage hormone receptor-positive breast cancer.
Talk to your clinician about the BCI test if you:
- Have been diagnosed with stage 1, stage 2 or stage 3 hormone receptor-positive breast cancer
- Have no cancer in your lymph nodes (also called lymph node-negative disease) or the cancer is lymph-node positive and in one, two or three lymph nodes
- Are considering taking or are already on anti-estrogen therapy and want to know if treatment will help reduce your risk for recurrence
What do the results of the Breast Cancer Index test tell you?
For most women, hot flashes, fatigue, joint pain and other side effects from anti-estrogen therapy seriously affect quality of life. Anti-estrogen therapies also increase the risk for osteoporosis (bone loss), blood clots and other cancers.
The BCI test helps patients and clinicians make important decisions about anti-estrogen therapy, including how long treatment should last.
The results of the BCI test predict:
- Individualized overall risk (0-10 years post-diagnosis) of the treated cancer returning somewhere else in the body (metastatic recurrence)
- Individualized late risk (5-10 years post-diagnosis) of metastatic recurrence
- Whether extended anti-estrogen therapy (past five years) will help reduce the risk for late recurrence
In the past, the BCI test was done five years after diagnosis to determine risk of late recurrence and whether longer anti-estrogen therapy would help reduce that risk. Now, as part of the new expanded BCI option, the test can be done earlier after diagnosis or early in treatment to provide more information that may help clinicians and patients develop a personalized treatment plan from the start.
For example, people who have low enough risk may want to consider a less aggressive treatment plan. For postmenopausal women, this may mean taking anti-estrogen treatments for a shorter amount of time. And women who are at minimal risk and premenopausal may not have to go through ovarian suppression.
Questions to ask your clinician about the Breast Cancer Index test
If you have hormone receptor-positive breast cancer or have a personal history of it, talk to your clinician about the BCI test.
It’s a good idea to write down your thoughts and concerns before the conversation and take them with you to your appointment.
Here are some questions to consider:
- Am I a candidate for the BCI test?
- How long will it take to get the results from the BCI test?
- How will the results affect my treatment plan?
- What are the downsides (if any) to the BCI test?
- Does insurance cover the test?
Final FYI on BCI
A breast cancer diagnosis is scary and overwhelming. But the BCI test can offer some clarity and help some people avoid potentially unnecessary treatments.
The BCI test is the only genomic test available that can predict risk of late distant recurrence and the benefit of extended endocrine therapy in people diagnosed with early-stage hormone receptor-positive breast cancer.
This educational resource was created with support from Hologic, a HealthyWomen Corporate Advisory Council member.
