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EndoPredict is a genomic test used to measure a person’s risk of breast cancer recurring from diagnosis through 15 years. The results are used, with other information about the cancer, to help determine whether you need chemotherapy after surgery.

You may hear EndoPredict called a prognostic test, which means it’s a test that predicts your likelihood of experiencing a particular medical event. Prognostic tests are different than diagnostic tests, which show whether you have a medical condition. Prognostic test results showing a high likelihood of recurrence do not guarantee that you’ll have a recurrence—but they can help you and your care team make treatment decisions.

EndoPredict is performed using tumor tissue taken during a biopsy or breast cancer surgery such as lumpectomy or mastectomy. The National Comprehensive Cancer Network (NCCN) and American Society of Clinical Oncology (ASCO) both support the use of EndoPredict in making decisions about post-surgery treatment and include it in their standard treatment guidelines.

EndoPredict can also be used to identify people who should continue taking endocrine therapy beyond the standard five years.

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Who is EndoPredict for?

EndoPredict can be used to test tumors from women who are postmenopausal or who are age 50 and over, and have:

  • Been diagnosed with hormone receptor-positive, HER2-negative breast cancer
  • Have zero to three lymph nodes testing positive for breast cancer
  • A biopsy tumor sample that has never been frozen

Right now, data are limited about how helpful genomic tests for early-stage breast cancer are in planning treatment for male breast cancer. Some data suggest that another genomic test result, the Oncotype DX Recurrence Score, may provide information on the risk of recurrence for men.

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How does EndoPredict work?

EndoPredict analyzes 12 genes to determine a Molecular Score. The Molecular Score is then analyzed with the tumor size and lymph node status to determine an EPclin Score, which predicts the likelihood of cancer recurrence within 10 years and whether chemotherapy may be helpful. EndoPredict can be used in early-stage hormone receptor-positive, HER2-negative breast cancer if there is no cancer in the lymph nodes or if cancer is in one to three lymph nodes.

The EPclin Score shows whether the cancer is at high risk or low risk of recurring within 10 years.

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What do EndoPredict results mean?

Your risk of recurrence will be reported as an EPclin Risk Score, a combination of EndoPredict’s Molecular Score, the tumor size, and the lymph node status.

Possible results include:

  • 1.0 to 3.3: Cancers in this group have a low risk (less than 10%) of distant recurrence within 10 years. Women with low scores may be able to go without chemotherapy treatment, depending on other features of the cancer.
  • 3.4 to 6.0: Cancers in this group have a high risk (10% or greater) of distant recurrence within 10 years. Chemotherapy will likely be recommended.
  • 6.0 to 8.2: Cancers in this group are reported as having a high risk of distant recurrence within 10 years. Chemotherapy will likely be recommended. However, scores greater than 6.0 were not validated in clinical trials. This means less is known about the accuracy of the result.

If the EPclin score is less than 1.0, your results report will not include it.

Your results will be sent to your doctors as a Breast Cancer Gene Expression Profile. The report includes your EPclin Score, the 12-gene molecular score, the tumor stage, and the lymph node status. It will also provide a percent chance of distant recurrence and the estimated absolute chemotherapy benefit. Your doctors will use all of this information to determine whether you can safely avoid chemotherapy after surgery.

If you’ve already completed five years of endocrine therapy without having chemotherapy, the report will also include a long-term treatment planning category that offers a percent chance of late distant recurrence in years five-15. Your doctors can use this category to help determine if you should continue taking endocrine therapy.

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Paying for EndoPredict

If you have private health insurance, your carrier may pay part or all of the cost of EndoPredict. It’s best to check your coverage before you have the test to avoid unexpected costs. Visit your insurance company’s online portal or call their customer service line to speak with someone about your plan’s coverage policy. Medicare and Medicaid may also provide some coverage of the cost of EndoPredict.

The maker of EndoPredict, Myriad Genetics, offers a financial assistance program for people who meet certain eligibility requirements. The financial assistance page of their website has more information about how to qualify, an application form, and a calculator to estimate what you’ll pay for EndoPredict based on your household income and family size.

For more information on financial assistance for breast cancer testing and treatment, visit our Financial Assistance page.

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Reviewed and updated: June 5, 2024

Reviewed by: Laura Huppert, MD

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