Predictive and prognostic markers for invasive breast cancer

Abstract

Breast cancer is one of the most serious carcinomas among women worldwide, yet there are now encouraging signs that improvements in the mortality rate may be possible. The use of hormone therapy and chemotherapy has been widely accepted as treatment for breast cancer. Predictive factors can be used to predict response or lack of response to a particular therapy, and prognostic factors can be useful in making decisions about which patients should receive adjuvant therapy. Histopathology remains the universal basis of diagnosis, with the identification of new surrogate markers for potential new treatments. These are aimed at blocking tumor cell proliferation, neutralizing growth factors, stimulating apoptosis and blocking metastasis, and represent an integral part of new approaches for improving clinical management of patients with breast cancer. We review the standard predictive and prognostic factors that are routinely available today, and also describe some of the new, potential markers that are currently under investigation.

Carbonic anhydrase-9 expression levels and prognosis in human breast cancer: association with treatment outcome

“…Its association with prognosis has been reported earlier in breast cancer , although this study included patients treated by adjuvant systemic therapy. The true prognostic value, however, of a given factor should be assessed in patients in the absence of adjuvant treatment (Hayes et al, 1998;Henderson and Patek, 1998;Barratt et al, 2002;Mori et al, 2002). Predictive factors can be used to predict response or lack of response to a particular therapy (Mori et al, 2002).…”

“…The true prognostic value, however, of a given factor should be assessed in patients in the absence of adjuvant treatment (Hayes et al, 1998;Henderson and Patek, 1998;Barratt et al, 2002;Mori et al, 2002). Predictive factors can be used to predict response or lack of response to a particular therapy (Mori et al, 2002). Each therapy should be evaluated independently in patient cohorts defined by a predictive factor (Henderson and Patek, 1998).…”

Estrogen Receptor and Progesterone Receptor Status in Breast Cancer in Relation to Age, Histological Grade, Size of Lesion and Lymph Node Involvement

“…An imbalance precipitates abnormal processes like epithelial hyperplasia, intraductal and 5048 invasive carcinoma (Mori et al, 2002). Estrogen is an important mitogen exerting its activity by binding to its receptor (ER) and found in 50-80% of breast cancers (Mori et al, 2002).…”

“…histologic type, grade, tumor size and lymphnode metastases. Estrogen and progesterone receptors (ER, PR) and more recently, HER-2/neu have with increasing importance influenced the management of the malignancy (Rampaul et al, 2001;Mori et al, 2002;Gowm et al, 2008).…”

Multivariate analysis of oestrogen receptor alpha, pS2, metallothionein and CD24 expression in invasive breast cancers

“…Also other methods of hormonal treatment are in use, including aromatase inhibitors, analogues of GnRH, etc. In advanced cases of breast cancer, in cases of a more aggressive course or in cases insensitive to hormonal therapy chemotherapy is used (Goldhirsch et al, 1998;National Institutes of Health Consensus Development Panel, 2001;Mori et al, 2002). As the hormonal treatment, as compared to chemotherapy, is much better tolerated by the patients the capacity to predict clinical response to tamoxifen and clinical course of the tumour becomes a significant aim in the diagnosis.…”