Adjuvant Therapy: Additional treatment such as radiation, chemotherapy, and endocrine therapy given after surgery to lower the chance of cancer coming back. Adjuvant chemotherapy and endocrine therapy are given after surgery in breast cancer.

Agendia Breast Cancer Test Suite: This is a suite of two genomic tests (MammaPrint + BluePrint) and when combined, look at the risk of disease recurrence and the molecular subtyping of the tumor.

BluePrint Molecular Subtyping Test: Part of the Agendia Breast Cancer Test Suite; the test analyzes 80 different genes to classify a tumor into its own unique molecular subtype. Each subtype responds differently to different categories of drugs and have varying long-term prognostic implications.

Breast Cancer Diagnosis: The disease may be initially detected in different ways, such as by feeling a lump that turns out to be cancerous; or through a screening mammogram. Potentially cancerous areas are then often imaged through MRI, ultrasound or other techniques. The actual diagnosis is typically made following a biopsy extraction of tissue, which is then examined under a microscope by a pathologist to see if cancer is present.

Breast Cancer Treatment: Breast cancer is treated in a variety of ways. Usually a doctor will perform surgery: either breast-conserving treatment followed by radiation therapy, or mastectomy that may be followed by surgical reconstruction. After surgery, you and your oncologist will decide which form of medical treatment best fits your tumor: hormone therapy and/or chemotherapy, and/or targeted therapy (e.g., Herceptin®). In certain situations, medical therapy with these medications will be given prior to surgery ( see Neoadjuvant Therapy).

Chemotherapy: Chemotherapy can be an effective treatment for properly selected patients. It is called a systemic therapy because the drugs enter the blood stream and travel throughout the body. It works by killing cells that divide rapidly, like cancer cells. Side effects may include hair loss, nausea, mouth sores, nerve damage and other problems.

Chromosome: A strand of DNA carrying genetic information in the form of genes. Humans have 22 pairs of these chromosomes plus the two sex chromosomes (XX in females and XY in males).

Endocrine Therapy: See Hormone Therapy.

ER, PR, and HER2 (Estrogen Receptor, Progesterone Receptor, Human Epidermal Growth Factor 2 Level): Your ER and PR levels are used to determine if your cancer will be receptive to hormone therapy. HER2/neu status helps determine if a targeted therapy, such as Herceptin, will be of benefit to you.

FISH (Fluorescence In Situ Hybridization): A type of test to detect a protein called human epidermal growth factor receptor-2 (HER-2). This protein is important for the growth of some breast cancers and is a target for therapy. If too much of this protein is produced, the tumor is considered HER2 positive. The FISH test will give a result of positive (HER-2 is over-expressed) or negative.

Gene: A gene is made of DNA that instructs your cells what to do. You can think of a gene as a kind of written directions for your cells.

Gene Expression: The process by which information from a gene is used to create biochemical material, such as RNA and proteins. These proteins direct the behavior of your cells.

Genetic Testing: A type of medical test that identifies inherited changes in chromosomes or genes . The results of a genetic test can confirm or rule out a suspected genetic condition or help determine a person’s chance of developing or passing on a genetic disorder or can determine if you have an abnormal change (also called a mutation) in a gene.

Genetics: Study of inherited traits, such as hair or eye color, that are passed from one generation to the next through genes.

Genomics: Study of the activity and interaction of certain genes in the body, including their role in certain diseases.

Genome: The complete set of your genes or genetic material.

Genomic Profile: Information about the genes’ expression and the way they interact with each other; in other words, how they behave.

Genomic Tumor Testing: A genomic test uses tissue from the tumor and looks at the activity of groups of genes within the tumor, to provide a more comprehensive view of your specific cancer.

Hormone Therapy: Typically used with breast cancers that are “estrogen-receptor positive” (ER+) and/or “progesterone receptor positive (PR+). Some tumors need estrogen and/or progesterone to keep growing. Hormone therapy either stops your body from making those, or blocks the receptors so the cancer cannot use the hormones for its growth.

Immunohistochemistry (IHC): A type of laboratory test used by pathologists to examine a tissue specimen for specific proteins. These may help to determine if cancer is present and if so, what type of cancer. For example, IHC can be used to help determine if a breast cancer has excessive amounts of the HER2 protein, and is HER2 positive (HER+).

Low/High Risk of Recurrence: If your tumor is “low-risk,” that means it is unlikely to come back after standard treatment. A “high-risk” tumor may require more extensive treatment such as chemotherapy.

Lymph Nodes: Part of the body’s lymphatic and immune system, they filter out harmful substances (including cancer cells) from lymphatic fluid. We have hundreds of lymph nodes throughout our body.

MammaPrint Breast Cancer Recurrence Test: Part of the Agendia Breast Cancer Test Suite panel. It classifies breast cancer as having either a Low Risk or a High Risk of recurrence. It examines 70 genes within the cancer that have been proven to be the strongest for predicting the risk of recurrence of breast cancer, and is the only test of its kind for women of all ages that will give a binary result (meaning either Low or High Risk).

Markers (also known as Biomarkers): These can include proteins that are often used as indicators of gene expression, or other types of substances that have a known link to a cancer.

Metastasis: The spread of cancer from one part of the body to another.

Molecular Subtype: In breast cancer, most studies divide breast cancer into four major molecular subtypes: Luminal A, Luminal B, Triple negative/basal-like, and HER2 type. The subtypes are defined by their active biological pathway that help determine the best course of treatment.

Neoadjuvant Chemotherapy: Chemotherapy taken before surgery.

Node Positivity (also known at Lymph Node Positivity): A finding of cancer cells in the lymph nodes indicating that the cancer may have a higher risk of spreading to other parts of the body.

Oncologist: A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a medical oncologist specializes in giving medications to treat cancer, while a radiation oncologist specializes in treating cancer with radiation.

Personalized Medicine: The relatively new practice of using information specific to you (such as your genomic profile) to personalize medical care and make it more precise, individualized and effective. It is also referred to as Precision Medicine.

Radiation Therapy: Treatment with high-energy rays (e.g., x-rays) to the breast to kill any remaining cancer cells and decrease the risk of cancer recurrence. Also called radiotherapy. Radiation therapy to the breast area is given after lumpectomy and sometimes after mastectomy. Radiation therapy can also be used on metastases.

Recurrence Risk: The likelihood (high or low) that your cancer will come back. Knowing this helps you and your doctor figure out how aggressive your treatment needs to be.

Targeted Therapies: Therapies which work on a specific target, usually a protein, which is important for the growth of a cancer and is more often present on the cancer than on normal cells. They are generally less likely than chemotherapy to harm normal, healthy cells because they mainly target the cancer cells, and thus tend to have fewer side effects. Herceptin is an example of a targeted therapy.

In the U.S., MammaPrint is an FDA cleared test, performed in a central laboratory using gene expression profiles obtained from formalin-fixed paraffin embedded (FFPE) breast cancer tissue samples, to assess a patient’s risk for distant metastasis within 5 years. BluePrint is a laboratory-developed test that was developed and is performed exclusively by Agendia.

In the EU, MammaPrint and BluePrint are CE marked tests, performed in a central laboratory, using gene expression profiles obtained from formalin-fixed paraffin embedded (FFPE) breast cancer tissue samples.