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Evidence to Improve Care

Gene Expression Profiling Tests for Early-Stage Invasive Breast Cancer

Final Recommendation

The Quality business unit at Ontario Health, based on guidance from 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 final recommendation report


Breast cancer is a disease in which 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)
March 2020


Related Resources

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


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The Ministry of Health has accepted this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review health technology assessments and funding recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.



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