TY - JOUR
T1 - Breast cancer prognostic classification in the molecular era
T2 - The role of histological grade
AU - Rakha, Emad A.
AU - Reis-Filho, Jorge S.
AU - Baehner, Frederick
AU - Dabbs, David J.
AU - Decker, Thomas
AU - Eusebi, Vincenzo
AU - Fox, Stephen B.
AU - Ichihara, Shu
AU - Jacquemier, Jocelyne
AU - Lakhani, Sunil R.
AU - Palacios, José
AU - Richardson, Andrea L.
AU - Schnitt, Stuart J.
AU - Schmitt, Fernando C.
AU - Tan, Puay Hoon
AU - Tse, Gary M.
AU - Badve, Sunil
AU - Ellis, Ian O.
N1 - Funding Information:
On 16 October 2008, the Susan G Komen for the Cure sponsored a meeting of pathologists to review and make recommendations regarding the utility of histological grade in breast cancer staging and prognostication. This report was conceived in that meeting. JSR-F is funded in part by Breakthrough Breast Cancer. The funding sources had no role in the literature search or in the drafting and approval of the manuscript.
PY - 2010/8/24
Y1 - 2010/8/24
N2 - Breast cancer is a heterogeneous disease with varied morphological appearances, molecular features, behavior, and response to therapy. Current routine clinical management of breast cancer relies on the availability of robust clinical and pathological prognostic and predictive factors to support clinical and patient decision making in which potentially suitable treatment options are increasingly available. One of the best-established prognostic factors in breast cancer is histological grade, which represents the morphological assessment of tumor biological characteristics and has been shown to be able to generate important information related to the clinical behavior of breast cancers. Genome-wide microarray-based expression profiling studies have unraveled several characteristics of breast cancer biology and have provided further evidence that the biological features captured by histological grade are important in determining tumor behavior. Also, expression profiling studies have generated clinically useful data that have significantly improved our understanding of the biology of breast cancer, and these studies are undergoing evaluation as improved prognostic and predictive tools in clinical practice. Clinical acceptance of these molecular assays will require them to be more than expensive surrogates of established traditional factors such as histological grade. It is essential that they provide additional prognostic or predictive information above and beyond that offered by current parameters. Here, we present an analysis of the validity of histological grade as a prognostic factor and a consensus view on the significance of histological grade and its role in breast cancer classification and staging systems in this era of emerging clinical use of molecular classifiers.
AB - Breast cancer is a heterogeneous disease with varied morphological appearances, molecular features, behavior, and response to therapy. Current routine clinical management of breast cancer relies on the availability of robust clinical and pathological prognostic and predictive factors to support clinical and patient decision making in which potentially suitable treatment options are increasingly available. One of the best-established prognostic factors in breast cancer is histological grade, which represents the morphological assessment of tumor biological characteristics and has been shown to be able to generate important information related to the clinical behavior of breast cancers. Genome-wide microarray-based expression profiling studies have unraveled several characteristics of breast cancer biology and have provided further evidence that the biological features captured by histological grade are important in determining tumor behavior. Also, expression profiling studies have generated clinically useful data that have significantly improved our understanding of the biology of breast cancer, and these studies are undergoing evaluation as improved prognostic and predictive tools in clinical practice. Clinical acceptance of these molecular assays will require them to be more than expensive surrogates of established traditional factors such as histological grade. It is essential that they provide additional prognostic or predictive information above and beyond that offered by current parameters. Here, we present an analysis of the validity of histological grade as a prognostic factor and a consensus view on the significance of histological grade and its role in breast cancer classification and staging systems in this era of emerging clinical use of molecular classifiers.
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U2 - 10.1186/bcr2607
DO - 10.1186/bcr2607
M3 - Review article
C2 - 20804570
AN - SCOPUS:78649992702
SN - 1465-5411
VL - 12
JO - Breast Cancer Research
JF - Breast Cancer Research
IS - 4
M1 - 207
ER -