New Developments in Breast Cancer and Their Impact on Daily Practice in Pathology

Abstract

Advances in research have transformed our understanding of breast cancers and have altered the daily practice of pathology. Theranostic evaluations performed by pathologists are now critical in triaging the patients into appropriate treatment groups, as are new guidelines that were recently established for the evaluation of HER2/neu gene amplification. Emerging molecular classifications of breast cancers bring novel perspectives to the assessment of individual cases, and opportunities for better treatments. Molecular studies have particularly shed light on distinct biological subsets of triple-negative breast cancers, for which new targeted therapies are being developed. The prognostic and therapeutic utility of new histopathologic parameters, such as tumor-infiltrating lymphocytes, are also being elucidated, and new protocols have been devised for the pathologic evaluation of breast specimens that have undergone neoadjuvant treatment. Novel clinical practices, such as radioactive seed localization, also affect the way breast specimens are processed and evaluated. In this brief review, we highlight the developments that are most relevant to pathology and are changing or could potentially impact our daily practice.

Signatures derived from increase in SHARPIN gene copy number are associated with poor prognosis in patients with breast cancer

“…Additionally, it is also classified according to gene expression profiles. Six intrinsic subtypes have been identified: luminal A and B (ER +), normal-like, Her2-enriched, basal-like, and claudin-low (the latter two being TN) BCs [2] , [3] , [4] , [5] . Furthermore, combination of gene copy number (GCN) variation and gene expression profile has divided BC into 10 integrative clustering sub-groups [6] .…”

Comparing breast biomarker status between routine immunohistochemistry and FISH studies and Oncotype DX testing, a study of 610 cases

“…Breast cancer is estimated to comprise nearly one‐third of new cancer diagnoses in women, and it remains the second most common cause of cancer‐related death . Prognostic markers for breast cancer include tumor size and type, lymph node status, Nottingham histologic grade, proliferation index, as well as estrogen receptor (ER), progesterone receptor (PR), and HER2 status, and others . ER‐positive (ER+) breast cancer generally has a better prognosis than ER‐negative (ER−) breast cancer.…”

Polyphenols as Promising Drugs against Main Breast Cancer Signatures

“…In this clinical scenario, new efforts have been made to obtain new drugs for breast cancer treatment leading to several promising molecules [ 4 ]. However, new molecules are still required.…”