What is Prosigna?
Prosigna is a test of gene activity in breast cancer. It assesses a patient’s pattern of genetic activity to provide a more accurate, personalised prediction about the risk of recurrence, and informs decisions about cancer treatment.
Fifteen years ago, researchers found that each breast cancer has one of four different patterns of gene activity. Each pattern can be associated with different risks of cancer recurrence, and with different responses to chemotherapy. The significance of these patterns of gene activity has now been described in thousands of medical publications.
Prosigna uses this information to help you and your patient decide whether certain treatments, such as chemotherapy, are warranted and, if so, what type of chemotherapy is likely to be the most effective. The accuracy of the Prosigna prediction has been proven in numerous independent studies involving thousands of women, and has been shown to be more reliable in determining the pattern of gene activity, and more accurate in predicting the risk of recurrence, than other genetic tests. This means that Prosigna provides a more secure basis for your decisions about cancer treatment than other tests.
The use of Prosigna has also been endorsed by independent international professional and regulatory organisations.
Uses of Prosigna
Prosigna has demonstrated utility in decision-making for neoadjuvant chemotherapy, adjuvant chemotherapy, adjuvant hormone therapy and chemotherapy after relapse. The studies involved both pre-menopausal and post-menopausal women. Prosigna provides more information, and is more accurate, than other genetic and immunohistochemical tests available in Australia. The utility of Prosigna extends to women at apparently low risk of recurrence by clinical criteria. In one study, one third of postmenopausal women at low risk of recurrence on clinical criteria were at high risk based on the more accurate estimates provided by Prosigna. Prosigna should be ordered by the clinician responsible for decision-making regarding adjuvant therapy for a woman with breast cancer. We recognise that Prosigna is not necessary for every woman facing significant decisions in breast cancer management, but it can provide important information in many instances.
To order Prosigna, please complete the special request form which is available here. Please provide the clinical information requested and attach a copy of the histology report and of any immunohistochemical studies. The patient is required to make prepayment for the test. This can be organised by phoning 1800 010 447 or calling their local Sonic Pathology Australia laboratory. The request form (and associated reports) are then faxed or emailed to our laboratory. We will contact the laboratory holding the FFPE sample to arrange transfer of the tissue sections necessary for the test. On receipt of the sections, the test takes 10 business days.
Prosigna costs $3,300; there is no Medicare rebate and the test must be prepaid. This is likely to be a significant expense for patients. To place this cost in context, adjuvant chemotherapy for breast cancer costs an average of $3,600 per month, with the patient being out of pocket for $199 per month. The costs to an individual patient are hard to predict. From a financial perspective, the decision to utilise adjuvant chemotherapy should not be taken lightly, and Prosigna can provide important information to assist in making that judgement.