Molecular profiling contributes more than routine histology and immonohistochemistry to breast cancer diagnostics

Excerpt

Initial enthusiasm to explore gene expression profiling and other high-throughput molecular methods as molecular diagnostic tools for breast cancer has given way to increasing skepticism. Several investigators suggested that these novel analytical methods may not have advanced diagnostic medicine beyond what optimally performed histology and immonohisto-chemistry (IHC) could deliver. There is some truth in this criticism, particularly when it comes to clinically useful assays that gene expression profiling methods have yielded. However, this overly simplistic assessment of molecular profiling overlooks three important contributions that high-throughput gene expression analysis has brought to breast cancer research and treatment. First, results from gene expression profiling studies have fundamentally changed our conceptual approach to breast cancer. Second, these methods have yielded several commercially available new diagnostic tests that fill a previously unmet diagnostic niche and have started to impact routine care, at least in the United States. Third, the impact of the large volume of molecular data that these studies have generated will have a lasting impact on breast cancer research. The in-depth analysis of the many tantalizing observations made from comprehensive genomic characterization of breast cancers has barely begun. …