--- title: "Genomic testing & therapies for breast cancer. | Sutter Health" description: "Given likely proliferation of testing & treatment strategies for cancer, a better understanding of the utilization patterns of HER2 testing & GEP are important." url: "https://www.sutterhealth.org/research/publications/genomic-testing-therapies-for-breast-cancer-1055312617" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Genomic testing & therapies for breast cancer. # Genomic testing & therapies for breast cancer in clinical practice. Haas JS, Phillips KA, Liang SY, Hassett MJ, Keohane C, Elkin EB, Armstrong J, & Toscano M. _J Oncol Pract. 7(3 Suppl):e1s-7s. doi: 10.1200/JOP.2011.000299_ 2011-05-01 ## Abstract PURPOSE: Given the likely proliferation of targeted testing and treatment strategies for cancer, a better understanding of the utilization patterns of human epidermal growth factor receptor 2 (HER2) testing and trastuzumab and newer gene expression profiling (GEP) for risk stratification and chemotherapy decision making are important. STUDY DESIGN: Cross-sectional. METHODS: We performed a medical record review of women age 35 to 65 years diagnosed between 2006 and 2007 with invasive localized breast cancer, identified using claims from a large national health plan (N = 775). RESULTS: Almost all women received HER2 testing (96.9%), and 24.9% of women with an accepted indication received GEP. Unexplained socioeconomic differences in GEP use were apparent after adjusting for age and clinical characteristics; specifically, GEP use increased with income. For example, those in the lowest income category (< $40,000) were less likely than those with an income of $125,000 or more to receive GEP (odds ratio, 0.34; 95% CI, 0.16 to 0.73). A majority of women (57.7%) with HER2-positive disease received trastuzumab; among these women, differences in age and clinical characteristics were not apparent, although surprisingly, those in the lowest income category were more likely than those in the high-income category to receive trastuzumab (P = .02). Among women who did not have a positive HER2 test, 3.9% still received trastuzumab. Receipt of adjuvant chemotherapy increased as GEP score indicated greater risk of recurrence. CONCLUSION: Identifying and eliminating unnecessary variation in the use of these expensive tests and treatments should be part of quality improvement and efficiency programs. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/21886507) ![Su-Ying Liang, Ph.D.](https://dyn.mktgcdn.com/p/cRIUee_GK3HEL1Wq8svqoUApvABjlwVVA-KUHVGzuNw/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Su-Ying Liang, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/su-ying-liang-phd-1049681030) ## Research topics - [All Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22All+Cancer%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.](https://www.sutterhealth.org/research/publications/characteristics-cancer-screening-asian-american-1055312854) Thompson CA, Gomez SL, Chan A, Chan JK, McClellan SR, Chung S, Olson C, Nimbal V, Palaniappan L. Cancer Epidemiol Biomarkers Prev. 23(11):2208-17. doi: 10.1158/1055-9965.EPI-14-0487. 2014 Nov 01 - Publication ### [Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality.](https://www.sutterhealth.org/research/publications/diffusion-gene-expression-profiling-breast-cancer-1055312821) Ponce NA, Ko M, Liang SY, Armstrong J, Toscano M, Chanfreau-Coffinier C, Haas JS. Health Aff (Millwood). 2015 Apr 1;34(4):609-15. doi: 10.1377/hlthaff.2014.1013. 2015 Apr 01 - Publication ### [The centralization of robotic surgery in high-volume centers for endometrial cancer patients--a study of 6560 cases in the U.S.](https://www.sutterhealth.org/research/publications/central-robotic-surery-centers-endometrial-cancer-1055312938) Chan JK, Gardner AB, Taylor K, Blansit K, Thompson CA, Brooks R, Yu X, Kapp DS. Gynecol Oncol. 2015 Jul;138(1):128-32. doi: 10.1016/j.ygyno.2015.04.031. Epub 2015 Apr 28. 2015 Jul 01 - Publication ### [Cancer disparity by race and ethnicity in Nebraska: 1991–2005.](https://www.sutterhealth.org/research/publications/cancer-disparity-by-race-and-ethnicity-in-nebraska-1055312884) Lin G, Filos V, Ryan J, Zhang Y, Pu J, Qu M. Nebraska Department of Health and Human Services. 2009 Jun 01 - Publication ### [Women’s out-of-pocket expenditures and dispensing patterns for oral contraceptive pills between 1996 and 2006.](https://www.sutterhealth.org/research/publications/oop-costs-dispensing-for-oral-contraceptives-1055312599) Liang SY, Grossman D, Phillips KA. Contraception. 83(6):528-36. doi: 10.1016/j.contraception.2010.09.013 2011 Jun 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/genomic-testing-therapies-for-breast-cancer-1055312617#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Genomic testing & therapies for breast cancer."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/genomic-testing-therapies-for-breast-cancer-1055312617#medicalscholarlyarticle","name":"Genomic testing & therapies for breast cancer in clinical practice.","headline":"Genomic testing & therapies for breast cancer.","abstract":"PURPOSE: Given the likely proliferation of targeted testing and treatment strategies for cancer, a better understanding of the utilization patterns of human epidermal growth factor receptor 2 (HER2) testing and trastuzumab and newer gene expression profiling (GEP) for risk stratification and chemotherapy decision making are important. STUDY DESIGN: Cross-sectional. METHODS: We performed a medical record review of women age 35 to 65 years diagnosed between 2006 and 2007 with invasive localized breast cancer, identified using claims from a large national health plan (N = 775). RESULTS: Almost all women received HER2 testing (96.9%), and 24.9% of women with an accepted indication received GEP. Unexplained socioeconomic differences in GEP use were apparent after adjusting for age and clinical characteristics; specifically, GEP use increased with income. For example, those in the lowest income category (\u003c $40,000) were less likely than those with an income of $125,000 or more to receive GEP (odds ratio, 0.34; 95% CI, 0.16 to 0.73). A majority of women (57.7%) with HER2-positive disease received trastuzumab; among these women, differences in age and clinical characteristics were not apparent, although surprisingly, those in the lowest income category were more likely than those in the high-income category to receive trastuzumab (P = .02). Among women who did not have a positive HER2 test, 3.9% still received trastuzumab. Receipt of adjuvant chemotherapy increased as GEP score indicated greater risk of recurrence. CONCLUSION: Identifying and eliminating unnecessary variation in the use of these expensive tests and treatments should be part of quality improvement and efficiency programs.","description":"Given likely proliferation of testing & treatment strategies for cancer, a better understanding of the utilization patterns of HER2 testing & GEP are important.","keywords":["All Cancer","Health Disparities","Women's Health"],"datePublished":"2011-05-01","url":"https://www.sutterhealth.org/research/publications/genomic-testing-therapies-for-breast-cancer-1055312617","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"21886507"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1200/JOP.2011.000299"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/21886507/","https://doi.org/10.1200/JOP.2011.000299"],"isPartOf":{"@type":"Periodical","name":"J Oncol Pract"},"author":[{"@type":"Person","name":"Haas JS"},{"@type":"Person","name":"Phillips KA"},{"@type":"Person","@id":"https://www.sutterhealth.org/research/investigators/su-ying-liang-phd-1049681030","name":"Liang SY","url":"https://www.sutterhealth.org/research/investigators/su-ying-liang-phd-1049681030"},{"@type":"Person","name":"Hassett MJ"},{"@type":"Person","name":"Keohane C"},{"@type":"Person","name":"Elkin EB"},{"@type":"Person","name":"Armstrong J"},{"@type":"Person","name":"Toscano M"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"All Cancer","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22All+Cancer%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Women's Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Women%27s+Health%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/genomic-testing-therapies-for-breast-cancer-1055312617","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/genomic-testing-therapies-for-breast-cancer-1055312617#breadcrumblist"}}} ```