Pathologic diagnosis of breast cancer patients: evolution of the traditional clinical-pathologic paradigm toward "precision" cancer therapy.
We present an updated account of breast cancer treatment and of progress toward "precision" cancer therapy; we focus on new developments in diagnostic molecular pathology and breast cancer that have emerged during the past 2 years. Increasing awareness of new prognostic and predictive methodologies, and introduction of next generation sequencing has increased understanding of both tumor biology and clinical behavior, which offers the possibility of more appropriate therapeutic choices. It remains unclear which of these testing methodologies provides the most informative and cost-effective actionable results for predictive and prognostic pathology. It is likely, however, that an integrated "step-wise" approach that uses the traditional clinical-pathologic paradigms coordinated with molecular characterization of breast tumor tissue, will offer the most comprehensive and cost-effective options for individualized, "precision" therapy for patients with breast cancer.
a Department of Pathology and Laboratory Medicine , University of Rochester Medical Center , Rochester , New York.
B M
BM
Turner
a Department of Pathology and Laboratory Medicine , University of Rochester Medical Center , Rochester , New York.
D G
DG
Hicks
D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D047628:Estrogen Receptor alpha / Q000235:genetics; D005260:Female; D018734:Genes, erbB-2 / Q000235:genetics; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D007150:Immunohistochemistry / Q000592:standards / Q000639:trends; D005810:Multigene Family; D057285:Precision Medicine; D011980:Receptors, Progesterone / Q000235:genetics
D014408:Biomarkers, Tumor; C506487:ESR1 protein, human; D047628:Estrogen Receptor alpha; D011980:Receptors, Progesterone
ER; HER2; PR; biomarkers; multi-gene assay; next generation sequencing; precision cancer therapy; prediction; prognosis; qRTPCR; review; targeted therapy breast cancer; traditional clinical-pathologic paradigm