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Oncology · UK

Precision medicine - breast cancer treatment fitted to your tumour.

Genomic testing, receptor profiling, liquid biopsy and inherited-gene panels - read together by a molecular tumour board - so your treatment matches the biology of your cancer, and you skip what you don’t need.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What breast cancer genomic testing costs in the UK.

Indicative ranges for the assays across our partner laboratories.

In short

£1,800–£3,400, reported in one to two weeks.

Test or service Indicative range
Oncotype DX 21-gene recurrence score £2,600–£3,200
Prosigna (PAM50) subtype and risk £1,800–£2,600
MammaPrint / BluePrint signature £2,400–£3,400
Comprehensive genomic profiling (tissue) £2,000–£4,500
Liquid biopsy (circulating tumour DNA) £1,200–£2,800
Germline BRCA / PALB2 gene panel £350–£900
Medical oncology consultation £250–£450

Prices vary by laboratory, by assay and by whether the test runs on tissue or blood. Targeted-drug costs, where a therapy is recommended, are quoted separately and depend on the agent and your insurance cover.

The problem

Two women, the same stage - and very different cancers.

Staging tells you how far a cancer has spread. It does not tell you how it behaves. Precision medicine reads the biology, so the treatment matches the tumour rather than the textbook.

  • Could you avoid chemotherapy?

    For many ER-positive, node-negative cancers a recurrence score shows chemotherapy adds little - sparing months of treatment you never needed.

  • Is there a targeted drug for you?

    HER2, PIK3CA, BRCA, PD-L1 and HRD each unlock specific therapies. Without testing, they stay invisible.

  • Plan the whole biology, once

    One molecular tumour board reads receptor status, sequencing, liquid biopsy and inherited genes together - not in disconnected pieces.

The journey

From diagnosis to a tailored plan - what happens, in order.

One team from first message through testing, molecular tumour board and treatment monitoring.

  1. 01

    Before

    You share your diagnosis

    A short, confidential form. Your pathology report, receptor status (ER, PR, HER2), grade, node status, any imaging and prior treatment, plus family history of breast, ovarian or prostate cancer.

  2. 02

    Before

  3. 03

    Before

    Sample collection

    Most assays run on the tumour block already stored by your pathology lab - no new operation needed. Germline testing is a simple blood or saliva sample. A liquid biopsy is a single blood draw.

  4. 04

    Before

    Genomic analysis

    The tissue assay reports a recurrence score or subtype signature; comprehensive profiling reads dozens to hundreds of genes for actionable mutations such as PIK3CA, ESR1, HER2 and homologous-recombination deficiency.

  5. 05

    Interpretation

    Molecular tumour board

    Your medical oncologist, pathologist and geneticist meet to interpret the results together and translate them into a concrete recommendation - chemotherapy or not, which targeted agents, and the sequence.

  6. 06

    Interpretation

    Your treatment discussion

    A full consultation where the plan is explained in plain English: what each result means, the expected benefit, the side effects, and any clinical trials you may be eligible for.

  7. 07

    After

    Treatment, monitoring and re-testing

    Delivery of the agreed therapy with your oncologist, side-effect support, and repeat liquid biopsies where useful to track response and catch emerging resistance mutations.

Typical end-to-end: 2–4 weeks from diagnosis to a tailored plan. Liquid biopsies can be repeated during treatment to track response.

When it helps

When precision testing changes the plan.

The situations where genomics earns its place, plus the one red flag that means urgent oncology rather than a routine test.

  • ER-positive, node-negative early cancer

    The classic question - do you need chemotherapy at all? A recurrence-score assay often shows the answer is no, sparing months of treatment.

  • HER2-positive disease

    HER2 status directs anti-HER2 antibodies (trastuzumab, pertuzumab) and antibody–drug conjugates such as trastuzumab deruxtecan - among the most effective targeted agents in breast cancer.

  • Triple-negative breast cancer

    PD-L1 testing guides immunotherapy with pembrolizumab, and germline BRCA status opens the door to PARP inhibitors.

  • Hormone-receptor-positive, advanced

    CDK4/6 inhibitors, plus testing for PIK3CA, ESR1 and AKT-pathway mutations that unlock targeted pills after endocrine therapy stops working.

  • Suspected inherited risk

    A strong family history, young age at diagnosis or triple-negative disease all point to germline BRCA1/2, PALB2 and related testing - which changes both treatment and screening for relatives.

  • Choosing between two reasonable options

    When surgery, endocrine therapy and chemotherapy are all on the table, genomics tips the balance towards the plan most likely to help you specifically.

  • Cancer that has stopped responding

    A liquid biopsy at progression can reveal a new, actionable resistance mutation - and a next line of targeted treatment.

  • Red flag: rapidly progressing or symptomatic disease

    New breathlessness, bone pain, jaundice or neurological symptoms need urgent oncology review the same week - not a routine genomics booking.

Testing options

The tools of precision oncology, explained.

What each test measures and the treatment decision it informs - from recurrence scores to liquid biopsy.

  • Recurrence-score assays

    Oncotype DX, Prosigna and MammaPrint read a defined gene set to estimate the chance of the cancer returning - and therefore whether chemotherapy adds meaningful benefit.

  • Receptor and protein testing

    ER, PR, HER2 and Ki-67 on the tumour tissue remain the foundation of breast cancer treatment and are refined, not replaced, by newer assays.

  • Comprehensive genomic profiling

    Next-generation sequencing of dozens to hundreds of genes on the tumour, flagging actionable alterations such as PIK3CA, ESR1, HER2 amplification and HRD.

  • Germline (inherited) testing

    A blood or saliva panel for BRCA1/2, PALB2 and related genes - guiding PARP inhibitor eligibility, surgical choices and screening for family members.

  • Liquid biopsy (ctDNA)

    A blood test that detects tumour DNA circulating in the bloodstream - useful for tracking response and catching resistance mutations without a fresh biopsy.

  • PD-L1 immunohistochemistry

    Measures a protein that predicts response to immunotherapy, chiefly in triple-negative disease.

  • Homologous-recombination deficiency (HRD)

    A signature of impaired DNA repair that predicts benefit from platinum chemotherapy and PARP inhibitors, beyond BRCA alone.

  • Molecular tumour board review

    The step that turns raw data into a plan - a multidisciplinary panel interprets every result together and agrees the recommendation.

Safety and honest limits

What precision medicine can - and cannot - do.

Genomics is powerful but not magic. The value lies in matching the right test to the right decision - and in reading the results with clear eyes.

  • A test only helps if it changes the plan

    If standard pathology already answers the question, we say so - and save you the cost.

  • Genomic reports carry uncertainty

    Some findings are "variants of uncertain significance" - changes we cannot yet act on.

  • Targeted therapies have real side effects

    CDK4/6 inhibitors affect blood counts, PARP inhibitors cause fatigue and nausea, immunotherapy can trigger immune-related inflammation. Every plan comes with a monitoring schedule.

  • Sparing chemotherapy is a genuine outcome

    For many women with ER-positive, node-negative disease, a low recurrence score means chemotherapy can be safely avoided - arguably precision medicine’s biggest everyday win.

  • Germline results affect your family

    A BRCA or PALB2 finding has implications for siblings and children. Testing is done with genetic counselling so those conversations are supported, not sprung on you.

  • Tissue may be limited

    Older or small biopsy samples can be insufficient for comprehensive sequencing. A liquid biopsy is often the practical fallback.

  • Turnaround takes time

    Most assays report in one to three weeks. For fast-moving disease your oncologist may start standard treatment while results are pending, then adjust.

  • Not everything on a report is fundable

    A profiling report may name drugs not yet approved or reimbursed in the UK. We are honest about what is licensed, what is available on trial, and what is private-pay only.

  • Red flags during treatment

    Fever on chemotherapy or immunotherapy, breathlessness, severe diarrhoea or a new rash need the same-day acute oncology line or A&E - never a routine call.

Reading your genomic report

Your genomic report in four parts. Read the last one first.

Whichever assays were run - recurrence score, sequencing or liquid biopsy - the summary your oncologist works from keeps to the same shape.

A UK medical oncologist reviewing a patient’s genomic report

A quiet reminder

Genomic language is dense and can read coldly - we translate it for you.

If you would like us to talk you through the report and what each finding means for your treatment before your consultation, just ask.

  1. 01 Header

    Subtype and receptor status

    Your cancer’s ER, PR, HER2 and Ki-67 status - the biological classification everything else builds on.

  2. 02 Result

    Recurrence score or signature

    The number or category from the genomic assay, and where it sits on the low/intermediate/high scale that guides the chemotherapy decision.

  3. 03 Findings

    Actionable alterations

  4. 04 Impression

    The recommendation

    Read this first: the tumour board’s plain-language plan - which treatments, in which order, and why - plus any trial options and family-testing advice.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Genomic testing is often covered when it will guide a funded treatment decision, and germline BRCA testing is covered under many genetic-risk pathways. Cover for individual targeted drugs varies.

Frequently asked

Everything we get asked about precision medicine.

Quick answers on avoiding chemotherapy, cost, NHS access, liquid biopsy and inherited risk.

  • What is precision medicine for breast cancer?

    It is the practice of tailoring breast cancer treatment to the specific biology of your tumour, rather than treating everyone with the same-stage cancer identically. Tests on the tumour tissue and on your blood - receptor status, gene-expression signatures, sequencing and inherited-gene panels - reveal which treatments are most likely to help you and which you can safely skip.

  • Will a genomic test tell me whether I can avoid chemotherapy?

    Often, yes. For hormone-receptor-positive, HER2-negative, node-negative early breast cancer, a recurrence-score assay such as Oncotype DX or Prosigna estimates the benefit chemotherapy would add. A low score usually means endocrine therapy alone is enough, sparing you chemotherapy. Your oncologist interprets the score alongside your age, tumour size and preferences.

  • How much does breast cancer genomic testing cost privately in the UK?

    Roughly £1,800–£3,400 for a recurrence-score or signature assay, £2,000–£4,500 for comprehensive genomic profiling, £1,200–£2,800 for a liquid biopsy, and £350–£900 for a germline BRCA/PALB2 panel with counselling.

  • Is this available on the NHS?

    Partly. NICE recommends Oncotype DX for intermediate-risk ER-positive, node-negative early breast cancer, and the NHS Genomic Medicine Service funds germline BRCA testing and some tumour sequencing through the National Genomic Test Directory. Access, eligibility and waiting times vary by region, which is why some patients choose to arrange testing privately and faster.

  • What is a liquid biopsy and when is it useful?

    A liquid biopsy is a simple blood test that detects fragments of tumour DNA circulating in the bloodstream. It is most useful when tissue is limited, when a fresh biopsy would be difficult, or when a cancer has started to progress and you want to check for a new, targetable resistance mutation such as ESR1 without another operation.

  • Does an inherited-gene result affect my relatives?

    Yes. A germline BRCA1/2 or PALB2 finding is heritable, so siblings and children may each carry a one-in-two chance of the same variant. Because of this, germline testing is always paired with genetic counselling, so you and your family can make informed decisions about testing, screening and risk-reducing options.

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