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Current Breast Cancer Reports

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01-09-2019 | Breast Cancer | Local-Regional Evaluation and Therapy (DM Euhus, Section Editor)

Pathology Meets Biology: the New Era of Breast Cancer Staging

Author: Agnieszka Dombrowska

Published in: Current Breast Cancer Reports | Issue 3/2019

Abstract

Purpose of Review

Breast cancer is now recognized to be a very heterogeneous disease. This complexity was recently reflected in the newest American Joint Committee on Cancer (AJCC) breast cancer staging, implemented in 2018. Although it seems very daunting, the new staging is based on both the anatomical extent of the disease and the prognostic factors such as hormonal and HER2 status, grade of the tumor, and genomic assays providing information regarding risk of recurrence. The purpose of this review is to illustrate the reasoning for the change in previous, solely an anatomically based breast cancer staging system and to report the updates.

Recent Findings

The research showed that evaluation of breast cancer through immunohistochemistry and utility of genomic assays provides substantial prognostic information.

Summary

The combination of anatomic and prognostic factors has a tremendous impact on outcome predictive abilities of the staging system for each affected individual.

•• Hortobagyi G, et al. Breast AJCC cancer staging manual. In: American College of Surgeons (ACS) Chicago Illinois 2017. 8th ed. This is the breast chapter published by AJCC and addressing all the updates in the eighth edition of the breast cancer staging.

• Giuliano A, et al. Breast cancer-major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. Ca Cancer J Clin. 2017. https://doi.org/10.3322/caac.21393. This is the editorial summary of the eighth edition AJCC breast cancer staging changes.

Polyak K. Heterogeneity in breast cancer. J Clin Invest. 2011;121:10–3788. https://doi.org/10.1172/JCI60534.CrossRef

Parker JS, et al. Supervised risk predictor of breast cancer based on intrinsic subtypes. J Clin Oncol. 2009;27(8):1160–7. https://doi.org/10.1200/JCO.2008.18.1370.CrossRefPubMedPubMedCentral

Gautam M, et al. Histological, molecular and functional subtypes of breast cancers. Cancer Biol Ther. 2010;10:955–60. https://doi.org/10.4161/cbt.10.10.13879.CrossRef

Goldhirsch A, et al. Strategies for subtypes—dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol. 2011;22(8):1736–47. https://doi.org/10.1093/annonc/mdr304.CrossRefPubMedPubMedCentral

Hon JDC, et al. Breast cancer molecular subtypes: from TNBC to QNBC. American Journal of Cancer Research. 2016;6(9):1864–72.PubMed

Russnes H, et al. Breast cancer molecular stratification. From intrinsic subtypes to integrative clusters. Am J Pathol. 2017;187(10):2152–62. https://doi.org/10.1016/j.ajpath.2017.04.022.CrossRefPubMed

Dias K, Dvorkin-Gheva A, Hallett RM, Wu Y, Hassell J, Pond GR, et al. Claudin-low breast cancer; clinical & pathological characteristics. PLoS One. 2017;12:1. https://doi.org/10.1371/journal.pone.0168669.CrossRef

10.

Perou CM. Molecular stratification of triple-negative breast cancers. Oncologist. 2011;16:61–70. https://doi.org/10.1634/theoncologist.2011-S1-61.CrossRefPubMed

11.

Lehmann B, et al. Identification of human triple-negative breast cancer subtypes and preclinical models for selection of targeted therapies. J Clin Invest. 2011;121(7):2750–67. https://doi.org/10.1172/JCI45014.CrossRefPubMedPubMedCentral

12.

Stemmer S, et al. Clinical outcomes in ER+ HER2 -node-positive breast cancer patients who were treated according to the recurrence score results: evidence from a large prospectively designed registry. NPJ Breast Cancer. 2017;3:32. https://doi.org/10.1038/s41523-017-0033-7.CrossRefPubMed

13.

Paik S, et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006;24:3726–34. https://doi.org/10.1200/JCO.2005.04.7985.CrossRefPubMed

14.

Morrow PK, Theriault R. Chapter 82. General NCCN guidelines. In: Kuerer HM, editor. Kuerer’s breast surgical oncology. New York, NY: McGraw-Hill; 2010.

15.

Cardoso F, et al. The MINDACT trial: the first prospective clinical validation of a genomic tool. Mol Oncol. 2010;1(3 (2007)):246–51. https://doi.org/10.1016/j.molonc.2007.10.004.CrossRef

16.

Whitworth P, et al. Chemosensitivity and endocrine sensitivity in clinical luminal breast cancer patients in the prospective Neoadjuvant Breast Registry Symphony Trial (NBRST) predicted by molecular subtyping. Ann Surg Oncol. 2017;24:669–75. https://doi.org/10.1245/s10434-016-5600-x.CrossRefPubMed

17.

Cardoso F, et al. 70-gene signature as an aid to treatment decisions in early-stage breast cancer. N Engl J Med. 2016;375(8):717–29. https://doi.org/10.1056/NEJMoa1602253.CrossRefPubMed

Title: Pathology Meets Biology: the New Era of Breast Cancer Staging
Author: Agnieszka Dombrowska
Publication date: 01-09-2019
Publisher: Springer US
Keywords: Breast Cancer
Breast Cancer
Biomarkers
Published in: Current Breast Cancer Reports / Issue 3/2019
Print ISSN: 1943-4588
Electronic ISSN: 1943-4596
DOI: https://doi.org/10.1007/s12609-019-00325-3

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Abstract

Purpose of Review

Recent Findings

Summary

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