Conventional and new emerging prognostic factors in breast cancer: an update. (December 2007)

• Record Type: Journal Article
• Authors: Nicolini, Andrea; Ferrari, Paola; Cavazzana, Andrea; Carpi, Angelo; Berti, Piero; Miccoli, Paolo
• Is Part Of: Biomarkers in medicine. Volume 1:Number 4(2007)
• Page Start: 525
• Page End: 540
• Publication Date: 2007-12
• Subjects: breast cancer -- genetic signature -- prognostic factors -- risk categories; Biochemical markers -- Periodicals; 610.28
• DOI: 10.2217/17520363.1.4.525
• Languages: English
• ISSNs: 1752-0363

Abstract

This article reviews the conventional clinicopathological, as well as the principal new emerging prognostic factors of breast cancer and proposes a tumor marker utility grading system for their use. In spite of the many advances in molecular biology toward better defining the biological aggressiveness of the primary malignancy, the conventional node-negative status, tumor size and grade are still the strongest predictors of relapse-free survival and/or overall survival. Microvessel count and bone-marrow micrometastases, among the more recently studied clinicopathological prognostic factors, and amplification and/or p53 mutation and S-phase fraction among the biological ones must be considered investigational, although, with enough documentation recommending their usefulness. Estrogen and/or progesterone expression, c-erbB-2 amplification and/or mutation are the prognostic factors currently included in the principal clinical guidelines. They also enable probable forecast of the response to endocrine treatment or chemotherapy. In particular, c-erbB-2 is used to define the different risk categories of node-negative operated breast cancer patients. In recent years, microarray and quantitative reverse-transcription PCR technologies have enabled the study of multiple genetic alterations and computer algorithms have been developed for visual recognition of tumors that share so-called ''signatures''. So far, different gene-expression patterns with different prognoses have been identified but methodological problems remain to be solved prior to routine use.