EndoPredict Breast Cancer Prognostic Test


Prof. Dr. med. Michael Untch, Head of Clinic for Gynecology, Gynecologic Oncology and Obstetrics, Head of Breast Interdisciplinary Cancer Center Department of Obstetrics and Gynecology, HELIOS Clinic Berlin-Buch in Berlin, Germany

Watch Prof. Untch’s case

  • 68 years old, pT1b (9 mm), N0, G2, L0, V0, PN0, R0, ER 100%, PR 15%, Ki67 40% early-stage breast cancer patient
  • Poll of other clinicians’ case opinions
  • How her EndoPredict result changed the treatment decision
  • Clinical validation of the test in this patient group

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Clear results

Informed conversations

Confident decisions

Get clear results

    Based on her individualized risk score. See her full report


risk of distant recurrence within 10 years


absolute individualized chemotherapy benefit


5–15 year late distant recurrence risk*
*with 5 years of endocrine therapy alone

Have informed conversations

   Simple to interpret, straightforward to explain. For example:

“Your result gave you a high-risk score”

“This is based on the activity of your genes and tumor
risk profile”

“There is a 19% risk your cancer will come back within 10 years, which is approximately 1 in 5”

“Having chemotherapy cuts this risk by 8%, to around
1 in 13”

Make confident decisions

   Knowing her result
  • Is from the most accurate prognostic1 and predictive test2

  • Combines her clinical factors with a molecular gene expression score3-5
  • Is clinically validated and prospectively confirmed2-10


  • Is recommended by international guidelines11-16

What this meant for this patient

Based on her clear result, this patient and her clinician decided to add adjuvant chemotherapy to her treatment plan. They could make this choice with confidence knowing that although chemotherapy might be difficult, it will significantly lower her risk of recurrence.

Her report breakdown

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  1. Sestak, Ivana et al. “Comparison Of The Performance of 6 Prognostic Signatures For Estrogen Receptor-Positive Breast Cancer.” JAMA Oncology, vol 4, no. 4, 2018, pp. 545-553
  2. Buus, Richard et al. “Comparison of EndoPredict and EPclin With Oncotype DX Recurrence Score for Prediction of Risk of Distant Recurrence After Endocrine Therapy.” Journal of the National Cancer Institute, vol. 108, no. 11, 2016, p.149.
  3. Filipits, Martin. “Prediction of Distant Recurrence Using EndoPredict Among Women with ER+, HER2− Node-Positive and Node-Negative Breast Cancer Treated with Endocrine Therapy Only.” Clinical Cancer Research, vol. 25, no. 13, 2019, pp. 3865–3872.
  4. Sestak, Ivana. “Prediction of chemotherapy benefit by EndoPredict in patients with breast cancer who received adjuvant endocrine therapy plus chemotherapy or endocrine therapy alone.” Breast Cancer Research and Treatment, vol. 176, 2019, pp. 377–386.
  5. Martín, Miguel. “Fluorouracil, Doxorubicin, and Cyclophosphamide (FAC) Versus FAC Followed by Weekly Paclitaxel As Adjuvant Therapy for High-Risk, Node-Negative Breast Cancer: Results From the GEICAM/2003-02 Study.” Journal of Clinical Oncology, vol. 20, 2002, pp. 2593-2599.
  6. Dubsky, Peter et al. “The Endopredict Score Provides Prognostic Information On Late Distant Metastases In ER+/HER2− Breast Cancer Patients.” British Journal Of Cancer, vol. 109, no. 12, 2013, pp. 2959-2964.
  7. Penault-Llorca, Frederique et al. “Prognostic value of EndoPredict test in patients screened for UNIRAD, a UCBG randomized, double blind, phase III international trial evaluating the addition of *** (EVE) to adjuvant hormone therapy (HT) in women with high risk HR+, HER2- early breast cancer (eBC)“. SABCS 2021, PD-09-08 Spotlight Poster Discussion 9
  8. Constantinidou, Anastasia. “Clinical Validation of EndoPredict in Pre-Menopausal Women with ER-Positive, HER2-Negative Primary Breast Cancer.” Clinical Cancer Research, vol. 28, no. 20, 2022, pp. 4435-4443.
  9. Vázquez-Juarez, Daniela et al. ”Follow-up of prospective cohort of Mexican premenopausal women with breast cancer who received guided adjuvant treatment with the EndoPredict assay.” SABCS 2021, P4-05-15
  10. Klein, Evelyn et al. “Abstract Reports: Long-term outcome data using Endopredict® as risk stratification and chemotherapy decision biomarker in hormone receptor positive, HER2-negative early breast cancer.” Cancer Research, 83, no.5S, pp01-24
  11. Andre, Fabrice et al. “Biomarkers for Adjuvant Endocrine and Chemotherapy in Early-Stage Breast Cancer: ASCO Guideline Update.” Journal of Clinical Oncology, vol. 40, no. 16, 2022, pp. 1816-46.
  12. Cardoso, Fàtima et al. “Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.” Annals of Oncology, vol. 30, no. 8, 2019, pp. 1194-1220.
  13. Gradishar, William et al. “NCCN Guidelines® Insights: Breast Cancer, Version 4.2021.” Journal of the National Comprehensive Cancer Network, vol. 19, no. 5, 2021, p. 484.
  14. Thomssen, Christoph et al. “St. Gallen/Vienna 2021: A Brief Summary of the Consensus Discussion on Customizing Therapies for Women with Early Breast Cancer.” Breast Care, vol. 16, 2021, pp. 135-143.
  15. Giuliano, Armando et al. “Breast Cancer–Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual,” CA: A Cancer Journal for Clinicians, vol. 67, 2017, p. 290-303
  16. National Institute for Health and Care Excellence. “Tumour profiling tests to guide adjuvant chemotherapy decisions in early breast cancer: Diagnostics guidance,” 2018