Prognostic and predictive factors of breast carcinoma: Beyond hormonal receptors and HER2

AbstractOver the last years, new molecular prognostic and predictive markers in malignant tumours have been daily proposed by basic researchers; their clinical application have consistently contributed to increase the Pathology Services workload; immunohistochemistry often surrogates other more sophisticated biotechnologies with acceptable results although in several cases molecular techniques look preferable. Breast cancer is a model widely studied and effort is made to improve therapeutic results. Conventional macro-microscopic parameters, evaluation by immunohistochemistry of Ki 67, ER, PR and HER2 status represent consolidated and standardised prognostic factors; ER, PR and HER2 status are also validated predictive markers; for HER2 status, in borderline cases, hybridisation in situ technologies, such as FISH, improve the definition of result.In future, other molecular markers for new targeted therapeutic approaches will be probably consolidated; the more promising of them are VEGF, Topoisomerase-alpha II, PTEN and other members of c-erbB (HER) family such as HER1 (EGFR) and HER 3