1. What is the EndoPredict test?
2. Who is EndoPredict for?
3. Why is it used? 
4. How does it work?
5. EndoPredict score
6. Availability and cost

1. What is the EndoPredict test?

EndoPredict is a test that predicts how likely breast cancer is to spread to somewhere else in the body (secondary breast cancer) within 10 years of diagnosis, in people who will be taking hormone therapy for at least five years.

2. Who is EndoPredict for?

The test is suitable for people recently diagnosed with early stage invasive breast cancer that:

  • Has not spread to the lymph nodes under the arm
  • Is oestrogen receptor positive (ER+)
  • Is HER2 negative (HER2-)

Sometimes the test may be considered for people whose breast cancer affects one to three lymph nodes under the arm. 

The test is not suitable for people whose breast cancer is oestrogen receptor negative or HER2 positive. 

3. Why is it used?

Your specialist may recommend the EndoPredict test to help decide if other treatments, particularly chemotherapy, are needed.  

Chemotherapy may be given after surgery to reduce the risk of breast cancer coming back in future.

Whether you’re offered chemotherapy depends on a number of features of your breast cancer. These include:

  • The size and grade of the cancer
  • Whether it has spread to any of the lymph nodes under the arm
  • Whether the cancer is hormone receptor and HER2 positive or negative

For some people the benefit of chemotherapy is clear, but for others it’s less clear.

4. How does it work?

The test is done on a small amount of breast cancer tissue already removed (for example during a core biopsy or surgery). The tissue is sent to a laboratory, usually outside your local hospital and sometimes in Germany, where the test is carried out.

The test looks at groups of genes found in breast cancer and features of the breast cancer to produce a score.

The results are given separately from your pathology report and are sent to your specialist usually within 7 to 10 days.

If your specialist has recommended you have hormone therapy before surgery, the test must be done on the tissue removed by a core biopsy before you start hormone therapy. 

5. EndoPredict score 

The test gives a score, known as an EPclin Risk score, that is reported as either low or high risk. 

Your specialist will use the score, along with other information about your breast cancer, to help decide what treatment to recommend. 

Low risk

A low risk score means it’s unlikely the breast cancer will spread to somewhere else in the body in the next 10 years.

Most people with a low risk score will not need chemotherapy.  

High risk

A high risk score means it’s more likely the breast cancer will spread to somewhere else in the body in the next 10 years.

Chemotherapy is recommended for most people with a high risk score.  

6. Availability and cost

If EndoPredict is suitable for you, it’s usually available on the NHS across the UK.

Most private healthcare companies will also cover the cost of the test. 

You can also pay for the test yourself, but your treatment team will need to order the test for you and will be sent the results to discuss with you. It costs around £1,500. 

Last reviewed: October 2021
Next planned review begins 2023

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