The Changing Role of Pathology in Breast Cancer Diagnosis and Treatment

Pathological examination has been the gold standard for diagnosis in cancer and its role has also included the elucidation of etiology, pathogenesis, clinicopathological correlation, and prognostication. The advent of newer technologies and the realization that breast cancer is heterogeneous has shifted the focus to prognostication, with increased attention being paid to the identification of morphological features and immunohistochemical markers of prognostic relevance. However, despite the massive efforts invested in the identification of immunohistochemical biomarkers in breast cancer the majority have not proven to be of value in multivariate analyses and only estrogen receptor, progesterone receptor, and Her2/neu expression have remained essential components of pathological examination. These 3 markers were initially employed for prognostication but their role in treatment also rendered them of predictive value. Newer molecular methods, especially high-throughput technologies, have shown that even morphologically similar subDr. Anthony S.-Y. Leong, MB, BS, MD Hunter Area Pathology Service Locked Bag 1, HRMC Newcastle, NSW 2310 (Australia) E-Mail aleong @ mail.newcastle.edu.au © 2011 S. Karger AG, Basel Accessible online at: www.karger.com/pat D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /2 /2 01 7 6: 10 :1 5 P M