If I could visualize my breast cancer in 10 years, …

1 Proceed with informed decisions precisely suited for I could visualize my breast cancer in 10 years, would I make different choices today?Unlock information unique to youThe decisions you make about your treatment take careful consideration. When first diagnosed with breast cancer , a lot of testing is done. The test results are usually things your doctor can physically see, such as the size of the tumor, what the cancer cells look like, and if the cancer has spread. These results fit together to help determine your treatment plan. The Prosigna breast cancer Gene Signature Assay measures information at a deeper biological level that your doctor can t see. It looks at 50 genes in your cancer cells to see if they are present, absent, or too active. Each woman s breast cancer has unique traits that reveal how your cancer might behave.

2 What your doctor wants to understandExamples of tools and data your doctor might useYour potential decisions, in consultation with your physicianScreeningAm I at risk for cancer ?Do you have family members with breast cancer ?Do you have genes or other factors that might increase your risk? Physical exam Mammogram Ultrasound/ MRI Genetic counseling Genetic testing BRCA1, BRCA2 Type of screening Frequency of screening Preventative surgery (mastectomy)DiagnosisI have a lump. What is it? Is it serious? Is it cancer or not? Is it early stage disease? Is it fast or slow growing? What are other traits of the tumor? Using tissue from surgery: Tumor size Lymph node involvement Degree of hormone and protein receptors present or absent such as ER, PR, ki67, and HER2 statusWill I need to do more than remove my tumor to treat and manage my cancer ?

3 Treatment PlanningI had surgery to remove my cancer . What is next?What type of treatment is most likely to work for you?What is the chance your cancer will come back within 10 years? Which treatment is right for me, based on the likelihood my cancer will return? Hormonal therapy Chemotherapy Radiation A combination of two or moreUnderstanding stages of breast cancer evaluationProceed with ahead to make decisions todayProsigna is a genomic test which identifies the likelihood your cancer may return to any part of your body over 10 years. This is known as distant recurrence. By assessing your risk, Prosigna can provide a more complete understanding of your breast utilizes the PAM50 gene signature to find the unique genetic fingerprint of your tumor, also referred to as subtype. Using an automated process, your subtype is combined with other factors including tumor size and number of involved lymph nodes to help determine your risk of distant recurrence.

4 Looking ahead 10 years may help you make more confident choices with an accurate assessment of riskA Prosigna report is delivered directly to your oncologist and includes two important results: Your Prosigna Score, which is a numerical value on a 0-to-100 scale. A lower number indicates your cancer is less likely to return. A higher number indicates there is a higher chance your cancer may return. Your Risk Category, (Low, Intermediate, or High) indicates how likely your cancer will return within 10 years. Your risk status in combination with other aspects, such as your age, other health issues, the size and grade of your tumor, and hormone receptors present in your breast cancer will help you and your oncologist make the best treatment decision for you. Personalize decisions about your breast cancerHistorically, most breast cancers that were hormone receptor positive would have received both hormonal therapy and chemotherapy to lower the chance of the cancer returning.

5 Advancement in science has shown that some types of breast cancer have a low risk of recurrence, and may be sufficiently treated with hormone therapy Conversely, we know that tumors with a high risk of recurrence will likely require more intense systemic intervention. Understanding your risk of recurrence will help identify a more personalized approach for your provides your physician additional information to help accurately assess your risk of a genomic breast cancer test is suited for these characteristicsNewly diagnosed, early stage (I or II) Invasive breast cancer treated with endocrine therapyHormone receptor positive (ER or PR)Lymph node-negative or Lymph node-positive with 1-3 positive nodesProceed with Technologies, Inc. 530 Fairview Avenue N | Suite 2000 | Seattle, Washington 98109 | 1-206-378-6266 | 2013 NanoString Technologies, Inc.

6 For more information, visit or e-mail 1008060402000204060801000100 Low Risk25 1008060402000204060801000100 Low Risk25 Data apply to patients being treated with endocrine therapy for 5 years as in the tested patient population. See Package Insert for further information on therapeutic regimens and tested patient population. It is unknown whether these findings can be extended to other patient populations or treatment schedules. Average DR rate observed in ABCSG-8 for patients within 10 Prosigna Score #:Tumor Size: 2cm Date Reported:Lymph Nodes: Node-negativeAssay Description:The Prosigna breast cancer gene signature assay measures the expression of 58 different genes to report the Prosigna Score, which is used along with the patient s nodal status to assign a risk classification defined by prespecified Prosigna Score Prosigna Score is derived from a proprietary algorithm based on the PAM50 gene signature1, and includes information on the correlation of the tumor s gene expression with four prototypical PAM50 molecular profiles, as well as proliferation and the pathologic tumor Trial Results.

7 Probability of Distant RecurrenceIn the clinical validation study, patients who were node-negative, with a Prosigna Score of 25 were in the low risk group. The low risk population averaged a 3% probability of distant recurrence at 10 Prosigna algorithm was used in retrospective analysis of the ABCSG-8 clinical trial which included more than 1400 patients with varying risks of distant recurrence. The retrospectively fitted model relating Prosigna Score to 10-year distant recurrence for node-negative patients in the ABCSG-8 study is displayed below. Patient Prosigna Score*:* The Prosigna Score ranges from 0 through 100 and correlates with the probability of distant recurrence (DR) in the tested population. Risk classification is provided to guide the interpretation of the Prosigna Score using cutoffs related to clinical Risk10% [7% 14%]Intermediate RiskHigh Risk16% [11% 22%]High RiskLow Risk3% [2% 6%]Low RiskGroup Average [95% Cl]Probability of Distant Recurrence at 10 Years (%)Modeled Probability95% Confidence Interval (CI)Observed Probability Prosigna ScoreSample Prosigna Patient Report: Low Risk of RecurrenceNanoString Technologies, Inc.

8 530 Fairview Avenue N | Suite 2000 | Seattle, Washington 98109 | 1-206-378-6266 | 2013 NanoString Technologies, Inc. For more information, visit or e-mail 1008060402000204060801000100 Low Risk25 1008060402000204060801000100 Low Risk25 Data apply to patients being treated with endocrine therapy for 5 years as in the tested patient population. See Package Insert for further information on therapeutic regimens and tested patient population. It is unknown whether these findings can be extended to other patient populations or treatment schedules. Average DR rate observed in ABCSG-8 for patients within 10 Prosigna Score #:Tumor Size: 2cm Date Reported:Lymph Nodes: Node-negativeAssay Description:The Prosigna breast cancer gene signature assay measures the expression of 58 different genes to report the Prosigna Score, which is used along with the patient s nodal status to assign a risk classification defined by prespecified Prosigna Score Prosigna Score is derived from a proprietary algorithm based on the PAM50 gene signature1, and includes information on the correlation of the tumor s gene expression with four prototypical PAM50 molecular profiles, as well as proliferation and the pathologic tumor Trial Results.

9 Probability of Distant RecurrenceIn the clinical validation study, patients who were node-negative, with a Prosigna Score of 25 were in the low risk group. The low risk population averaged a 3% probability of distant recurrence at 10 Prosigna algorithm was used in retrospective analysis of the ABCSG-8 clinical trial which included more than 1400 patients with varying risks of distant recurrence. The retrospectively fitted model relating Prosigna Score to 10-year distant recurrence for node-negative patients in the ABCSG-8 study is displayed below. Patient Prosigna Score*:* The Prosigna Score ranges from 0 through 100 and correlates with the probability of distant recurrence (DR) in the tested population. Risk classification is provided to guide the interpretation of the Prosigna Score using cutoffs related to clinical Risk10% [7% 14%]Intermediate RiskHigh Risk16% [11% 22%]High RiskLow Risk3% [2% 6%]Low RiskGroup Average [95% Cl]Probability of Distant Recurrence at 10 Years (%)Modeled Probability95% Confidence Interval (CI)Observed Probability Prosigna ScoreGetting tested is easyAsk your surgeon and/or oncologist how Prosigna can help guide your decisions.

10 The Prosigna test does not require additional surgery or needle sticks. Prosigna can be performed on tissue preserved from your original surgery. It is the only breast cancer genomic test that is FDA-cleared to use this type of tissue*. Ask your doctor today for your Prosigna is indicated for use in postmenopausal women with hormone receptor-positive, node-negative or node-positive early-stage (stages I and II) breast cancer to be treated with adjuvant endocrine (hormone) therapy when used in conjunction with other clinicopathologic factors. Prosigna is not intended for diagnosis, to predict or detect response to therapy, or to help select the optimal therapy for the Prosigna Package Insert for full intended use.*formalin-fixed paraffin embedded tissueProsigna demonstrated the ability to accurately predict distant recurrence in clinical studies of over 2400 patients, of which over 1000 were compared directly to first-generation genomic breast cancer assays.