title: Prediction and prognosis: impact of gene expression profiling in personalized treatment of breast cancer patients.
abstract: Breast cancer is a complex disease, whose heterogeneity is increasingly recognized. Despite considerable improvement in breast cancer treatment and survival, a significant proportion of patients seems to be over- or undertreated. To date, single clinicopathological parameters show limited success in predicting the likelihood of survival or response to endocrine therapy and chemotherapy. Consequently, new gene expression based prognostic and predictive tests are emerging that promise an improvement in predicting survival and therapy response. Initial evidence has emerged that this leads to allocation of fewer patients into high-risk groups allowing a reduction of chemotherapy treatment. Moreover, pattern-based approaches have also been developed to predict response to endocrine therapy or particular chemotherapy regimens. Irrespective of current pitfalls such as lack of validation and standardization, these pattern-based biomarkers will prove useful for clinical decision making in the near future, especially if more patients get access to this form of personalized medicine.
authors.affiliation: Department of Obstetrics & Gynecology, Center for Integrated Oncology, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany  ; LIMES (Life and Medical Sciences Bonn) Institute, Genomics and Immunoregulation, University Bonn, Carl-Troll-Strasse 31, 53115 Bonn, Germany.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Mallmann
authors.forename: Andrea
authors.initials: A
authors.lastname: Staratschek-Jox
authors.forename: Christian
authors.initials: C
authors.lastname: Rudlowski
authors.forename: Michael
authors.initials: M
authors.lastname: Braun
authors.forename: Andrea
authors.initials: A
authors.lastname: Gaarz
authors.forename: Matthias
authors.initials: M
authors.lastname: Wolfgarten
authors.forename: Walther
authors.initials: W
authors.lastname: Kuhn
authors.forename: Joachim L
authors.initials: JL
authors.lastname: Schultze