HIQA on Gene Expression Profiling Tests for Breast Cancer

By Danélia Botes

February 21, 2023


There is an ongoing and unrelenting effort to find better treatments for breast cancer, which is a major health concern worldwide. One promising development in this respect is the use of gene expression profiling (GEP) tests. These tests, performed on tumour samples from early-stage breast cancer patients, can help determine the potential benefits of chemotherapy post-surgery.

Gene Expression Profiling Tests in Breast Cancer:

The Health Information and Quality Authority (HIQA) recently published a rapid health technology assessment (HTA) on GEP tests for breast cancer. This was at the request of the Health Service Executive’s (HSE) National Cancer Control Programme. These tests are particularly useful for patients with the most common form of breast cancer in Ireland. The tests aim to estimate the likelihood of the disease returning and the potential effectiveness of chemotherapy in preventing recurrence.

The Oncotype DX® Test:

Currently, the HSE covers the cost of one GEP test, known as Oncotype DX®. When it comes to patients whose cancer has migrated to their lymph nodes, this test has demonstrated the most compelling proof of its usefulness. On the other hand, the data that supports its use for patients whose cancer has not progressed to their lymph nodes is very restricted.

The Future of GEP Tests:

Despite the promising results of Oncotype DX®, the costs of other GEP tests are not covered. HIQA’s assessment examined the evidence for all four commercially available tests in Ireland. The aim was to provide advice to the HSE on potential alternatives. The decision to cover the cost of other GEP tests will need to consider factors such as patient group applicability, cost, and practicality of use in Ireland.


Shelley O’Neill, who is the Deputy Director of HTA at HIQA, pointed out that GEP tests have the potential to identify individuals who might not require chemotherapy. This would be beneficial to both the patient and the healthcare system. We need to collect more data on the use of GEP tests in Ireland. This would lead to a more comprehensive evaluation of the potential applications of these tests in the future.

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