5.1.1.2 Radiation Therapy (RT) BC Cancer Strategy

Author: Dr. Theodora Olivotto

See Breast Clinical Care Pathway

5.1.2 Systemic management​

See Breast Clinical Care Pathway

• American Society of Clinical Oncology
• European Society for Medical Oncology

Please see the following national consensus guidelines:

• ​Current Oncology | Special Issue : REAL Canadian Breast Cancer Alliance Collection

Criteria for consideration of chemotherapy

For patients with ER+ Her2- breast cancer, consideration of relative benefit of chemotherapy in the adjuvant setting can be assisted by utilization of a genomic assay associated with recurrence risk.  Among available genomic assays, Oncotype DX is the preferred test for predicting chemotherapy benefit in early-stage HR+ breast cancer in BC. Eligibility criteria for BC Cancer re​imbursed testing are outlined below. 

Table 3. Minimum eligibility criteria for BC funded Oncotype Dx Assay®

For all subtypes of breast cancer, (HR+, TNBC, Her2+), systemic therapy is offered based on risk assessment, disease features, and patient factors.  BC Cancer endorses national and international guidelines for systemic therapy in breast cancer (links here). As treatment options are ever evolving with new science and data we recommend reviewing annual updates from national and international meetings regularly (ESMO, ASCO, CAMO, NICE UK).

Please see national consensus guidelines Hormone Receptor Positive Breast Cancer:

• ​Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HR+/HER2− Early Breast Cancer 2025
• Guidance for Canadian Breast Cancer Prac​tice: National Consensus Recommendations for the Systemic Treatment of Patients with HR+/HER2− Metastatic Breast Cancer 2025[KN1] [CS2] ​

5.1.2.1 Viral illness considerations and chemotherapy​

• SCHBV_Protocol
• BC Cancer Immunization Recommendations​