[1]Kentaro,Tamaki,Hironobu,等.New development of breast cancer histological evaluation related to determination of therapeutic option for the patients[J].中华乳腺病杂志(电子版),2011,5(6):721-728.
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New development of breast cancer histological evaluation related to determination of therapeutic option for the patients()

中华乳腺病杂志（电子版）[ISSN:1674-0807/CN:11-9146/R]

卷:
第5卷
期数:
2011年6期
页码:
721-728
栏目:
综述
出版日期:
2011-12-01

文章信息/Info

作者:
Kentaro;Tamaki;Hironobu;Sasano
Department of Breast Surgery, Nahanishi clinic, Okinawa, Japan (Kentaro Tamaki); Department of Pathology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku Sendai, Miyagi 980-8574, Japan (Kentaro Tamaki, Hironobu Sasano)
关键词:
breast neoplasms;  histological evaluation;  therapy
摘要:
Breast cancer is a heterogenous disease with molecular alterations, cellular composition, and clinical outcome. The more we know about the tumor characteristics underlying the heterogeneity of the disease, the greater the opportunity to refine treatment options. Great emphasis has been placed upon histopathological characteristics of breast carcinoma cells in order to define better treatment options for breast cancer patients[1-2]. The recommendations of St. Gallen 2009 reported eight characteristics which favor the use of chemotherapy, and in particular those that might justify endocrine therapy alone. Four out of the eight characteristics have been defined by histopathological analysis including estrogen receptor (ER) and progesterone receptor (PR) status, histological grade, cell proliferation and peritumoral vascular invasion. The features indicating increased risks of recurrence and thus indirectly supporting the value of adding chemotherapy to endocrine therapy in those patients include lower expression of steroid hormone receptors, grade 3 tumors, high proliferation of carcinoma cells and extensive peritumoral vascular invasion . In addition, St. Gallen 2011 focused on intrinsic subtypes defined by ER, PR, HER-2, histological grade and Ki-67[2-4] . They defined luminal A as ER positive and PR positive, HER-2 negative and 14% or less of Ki-67 labeling index, and luminal B as ER positive and/ or high Ki-67 and/or histological grade 3 with or without HER-2 positive. And it was demonstrated that factors recommending for inclusion of chemotherapy included histological grade 3, more than 14% of Ki-67 labeling index, low hormone receptor status, positive HER-2 status and triple negative status. 82. 9% of the panels of this meeting agreed that for practical purposes tumor subtypes can be ascertained by non-genetic tests for ER, PR, HER-2 and Ki-67, which is and will be quite relevant in the clinical practice at least in Asian countries considering astronomically expensive price tag of these genetic tests. In addition, 75. 6% of the panels disagreed the choice of therapy depends on tumor subtype as defined by multi-gene array analysis, which is also quite reasonable considering the marked value of simple histological analysis. Therefore, it becomes increasingly important that the clinicians are provided with accurate histopathological information in order to base therapeutic decisions. This brief review article summarizes the analysis of histopathological diagnoses of breast carcinoma including ER and PR expressions, HER-2 status, Ki-67 labeling index and other histopathological factors which clinicians should know when seeing the pathology report of the patients.

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更新日期/Last Update: 2011-01-20