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

1. What is the Prosigna test?

Prosigna is a test that predicts how likely breast cancer is to spread to somewhere in the body within 10 years in people who will be taking hormone therapy for at least five years.

2. Who is Prosigna for?

The test is suitable for postmenopausal women recently diagnosed with early stage breast cancer that:

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

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

3. Why is it used?

Your specialist may consider recommending the Prosigna 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 the future.  

4. How does it work?

The test is done on a small amount of breast cancer tissue removed during your surgery and doesn’t involve having any more tissue removed. The tissue is sent to a laboratory that may be outside your local hospital, 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 3 to 10 days.

5. Prosigna results 

The test gives a score between 0 and 100. Based on this score and whether any lymph nodes under the arm are affected, the results are reported as ‘low’, ‘intermediate’ 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 won’t need chemotherapy.  

People are at low risk if they have:

  • negative lymph nodes and a score of 0–40 
  • up to three positive lymph nodes and a score of 0–15 

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.  

People are at high risk if they have:

  • negative lymph nodes and a score of 61–100 
  • up to three positive lymph nodes and a score of 41–100 

Intermediate risk

An intermediate risk score means the decision to have chemotherapy or not is less clear.

Your specialist will discuss your test result with you to help decide what to recommend.

People are at intermediate risk if they have:

  • negative lymph nodes and a score of 41–60
  • up to three positive lymph nodes and a score of 16–40 

6. Availability and cost

If Prosigna 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. 

Last reviewed: January 2019
Next planned review begins 2021

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