[A plea for selective use of the MammaPrint test].

Recently, the results of the MINDACT study were published in The New England Journal of Medicine. The authors conclude that the MammaPrint test can prevent the use of chemotherapy in about 50% of breast cancer patients with a high-risk clinical profile because of the presence of a genomic low risk MammaPrint. We believe that the decision to use chemotherapy should not be based solely on the outcome of the MammaPrint test, as is suggested by the authors, but also on clinical factors, such as tumour size, nodal status and grade. We demonstrate that the use of MammaPrint should be limited to those patients in whom the survival benefit of chemotherapy on the 10-year survival rate is 2-4%, as calculated with New Adjuvant Online, and assuming that patients consider an absolute survival benefit of 3% or more due to chemotherapy worthwhile.