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Evidence to Improve Care

Gene Expression Profiling Tests for Early-Stage Invasive Breast Cancer

Draft Recommendation

  • Health Quality Ontario, under the guidance of the Ontario Health Technology Advisory Committee, recommends publicly funding gene expression profiling tests for people with early-stage invasive breast cancer whose tumours have all of the following characteristics:

    • Estrogen receptor (ER)–positive

    • Human epidermal growth factor receptor 2 (HER2)–negative

    • Lymph-node–negative or micrometastasis

Read the draft recommendation report

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This topic is now available for public feedback until October 14, 2019. Please feel free to forward this page to any individual you think may be interested in reviewing this assessment. All comments will be considered before a final recommendation is made and posted here.

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Breast cancer is a disease where cells in the breast grow out of control. Treatment in the early stages typically involves surgery but there is a chance that the cancer will come back. A challenge is whether to recommend chemotherapy after surgery because of the negative side effects.

Gene expression profiling tests analyze a sample of the breast cancer tissue to identify the presence or absence of certain genes in the cancer cell. This information may help physicians determine the likelihood that the cancer will return after surgery and can help guide decisions about whether a person may benefit from chemotherapy.

This health technology assessment looked at how safe and effective gene expression profiling testing is for people with early-stage invasive breast cancer. It looked at the cost-effectiveness and the budget impact of publicly funding gene expression profiling tests. It also looked at the experiences, preferences, and values of people with early-stage invasive breast cancer.

The assessment was conducted in collaboration with the Canadian Agency for Drugs and Technologies in Health (CADTH) and the Institute of Health Economics (IHE). CADTH completed a rapid review of the qualitative evidence of patient preferences.

Read the full Health Technology Assessment report for more information.


Gene Expression Profiling Tests for Early-Stage Invasive Breast Cancer: A Health Technology Assessment (PDF)
September 2019


Related Resources

Gene Expression Profiling Tests for Breast Cancer: A Rapid Qualitative Review
April 2019


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We reviewed evidence on the use of Gene Expression Profiling Tests for Early-Stage Invasive Breast Cancer. Read the latest draft recommendation from Health Quality Ontario and share your feedback.

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Date posted: September 24, 2019
Closing date for public comment: October 14, 2019




About Health Quality Ontario

Health Quality Ontario is the provincial lead on the quality of health care. We help nurses, doctors and other health care professionals working hard on the frontlines be more effective in what they do—by providing objective advice and data, and by supporting them and government in improving health care for the people of Ontario.

We focus on making health care more effective, efficient and affordable through a legislative mandate of:

  • Reporting to the public, organizations, government and health care providers on how the health system is performing,

  • Finding the best evidence of what works, and

  • Translating this evidence into clinical standards; recommendations to health care professionals and funders; and tools that health care providers can easily put into practice to make improvements.


For more information about Health Quality Ontario, visit hqontario.ca.


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