From GenomeWeb re ER+ recurrence risk

Breast Cancer Recurrence Risk Predicted by Immune-Related Germline Variants

This article appearing on GenomeWeb.com today (Nov. 1) says that for ER+ breast cancer patients, the immune system may play a greater role than previously suspected or postulated. Note that the "genetics" cited are those of the tumor cells themselves, not of the patients' genetic-mutation (e.g., BRCA) status. The study found that its findings closely tracked those of OncotypeDX, which examines expression of 21 genes in the tumor cell--but that OncotypeDX is still slightly more predictive.

OncotypeDX generally doesn't predict recurrence beyond 10 years; other online calculators go only as far as 15 yrs. out. ER+ invasive b.c., even if caught very early, is notorious for recurring 15-30 years out, more often distantly than contralaterally or loco-regionally. So perhaps an immune-based germline gene test should be developed to, in conjunction with OncotypeDX, determine who can benefit from extending endocrine therapy vs. for whom the burdens exceed the benefits.