Genomic Testing Empowers Patient Agency in Breast Cancer Survivorship

For many premenopausal women diagnosed with breast cancer, the journey doesn't end with the completion of initial treatment. Instead, they face a daunting new normal defined by long-term endocrine therapy that can last a decade. These treatments, while life-saving, often come with a heavy price: significant impacts on fertility, bone health and daily quality of life.

Kassiane Saieed, an oncology nurse practitioner at Duke Women’s Cancer Care Raleigh, is on the front lines of changing this narrative.

In a recent interview with CURE, Saieed highlighted how precision oncology is providing objective data to replace what-ifs. Specifically, she points to the Breast Cancer Index (BCI) as a game-changer for women weighing the decision to continue or stop therapy.

“It is the year 2026,” Saieed notes, emphasizing that the era of one-size-fits-all medicine is over. Rather than placing a patient in a broad bucket based on general clinical pathology, genomic tools allow providers to look a patient in the eye and discuss a report based on their own specific tumor.

The power of this technology lies in its ability to foster patient agency. Saieed describes a common clinical scenario: a test result might show a 15% risk of recurrence. To a provider, that number might feel high and cause clinical anxiety. However, for a patient who has spent five years struggling with treatment side effects, that same report might indicate they don't need another five years of therapy.

“I've had patients just be so exalted that they don't need another five years,” Saieed said. By putting the data directly into the hands of the patient, the decision-making power shifts. “It puts the ball in the patient’s court,” she explained, allowing them to digest the numbers based on their own personal values and goals.

This personalized approach is the cornerstone of Saieed’s practice. While she relies on evidence-based practice as her foundation, her ultimate goal is to ease the burden of overwhelming days and listen to what matters most to each individual.

By utilizing these reports, Saieed and her team ensure that the treatment trajectory is not just a medical mandate, but a collaborative choice that honors the patient's long-term health and personal autonomy.

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