Significant evidence supporting the use of genomic predictors to guide adjuvant treatment decisions in women with ER+ breast cancer has emerged in recent years. Despite this, many countries do not routinely use these tests in breast cancer management. Martine Piccart, MD, PhD, Université Libre de Bruxelles, Brussels, Belgium, shares her thoughts on the importance of implementing genomic predictors globally to replace the currently used suboptimal factors, given the evidence of their efficacy and cost-effective nature. This interview took place during the 17th St. Gallen International Breast Cancer Conference.