多基因检测是乳腺癌早期（BC）中雌性激素受体阳性/人类表皮生长因子受体2阴性（ER + /HER2-）辅助治疗选择的重要工具。这些检测的工作流程，无论是外部化还是内部实施，都会为病理学实验室产生工作量，这常常被低估，并且会影响及时治疗的开始。在此，我们描述了病理学实验室使用多基因检测的不断发展作用，以及在提供分子分析所需组织方面提供适当支持的作用。此外，我们提出了一个“反射测试”模型，根据预先指定和共享的标准，期望病理学家独立进行多基因检测，而无需进行 ER + /HER2- BC 患者的多学科团队讨论，从而优化周转时间和适当治疗干预。

Multigenic tests represent an essential tool for the selection of adjuvant therapy in estrogen-positive/HER2-negative (ER + /HER2-) early breast cancer (BC). The workflow of these tests, either if they are externalized or carried out in-house, generates a workload for the pathology laboratories, that is often underestimated and may affect timely therapy initiation. Here, we describe the evolving role of pathology laboratories in using multigenic tests and, more in general, in providing adequate tissue for molecular analyses. Moreover, we propose a “reflex testing” model, in which pathologists, based on pre-specified and shared criteria, are expected to action multigene testing independently of multidisciplinary team discussion in ER + /HER2- BC patients, in order to optimize turnaround time and proper therapy intervention.