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The page below is a sample from the LabCE course Breast Cancer Predictive Markers. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Predictive versus Prognostic

Predictive factors can sometimes be confused with prognostic factors. While both types of information do assist in providing information on the likely progression of a patient's disease, the terms prognostic and predictive differ in the following way:

Prognostic factors provide information on clinical outcome at the time of cancer diagnosis, independent of therapy. Prognostic factors provide information on growth, invasion, and metastatic potentials.
Predictive factors provide information on the likelihood of response to a given therapy. Some markers can provide both predictive and prognostic value. For example, estrogen receptor (ER) testing in breast cancer can be used to both predict response to a specific hormone therapy and is a factor that correlates closely with favorable short term prognosis.
The most commonly applied predictive testing methods that are used to identify various subtypes of human breast cancer are:
  • Estrogen receptor (ER) by immunohistochemistry (IHC)
  • Progesterone receptor (PR or PgR) by IHC
  • Human epidermal growth receptor 2 (HER2 or HER2/neu) by IHC or HER2 amplification status by in situ hybridization (ISH), chromogenic in situ hybridization (CISH), or fluorescent in situ hybridization (FISH)
The results of these tests provide specific information, which is used to determine specific treatments.