ESMO E-Learning: Clinical Importance of New Molecular Classifications for Localised Breast Cancer
- To define molecular subtypes of breast cancer.
- To summarise clinical implications of breast cancer molecular classification and describe difficulties in translating molecular advances into clinical practice.
- To describe how to optimise selection of adjuvant medical treatment in breast cancer patients.
Breast cancer is a heterogeneous disease, comprising numerous distinct entities that have different biological features and clinical behaviour. Histological tumour grade and tumour type are two of the most important intrinsic characteristics and recent studies have demonstrated a moderate to good correlation between molecular tests and histological grade.
High-throughput, microarray-based gene-expression methods, have been extensively applied in breast cancer, to determine the molecular features that underpin metastatic propensity or histological grade and to identify signatures associated with prognosis and response to therapy. The gene-expression profiling of primary invasive breast cancers has led to the development of a molecular classification of breast cancer that comprised four molecular subtypes (basal-like, HER2, normal-breast like and luminal) based on a hierarchical Clustering analysis. Furthermore, the prognostic significance of the molecular classification has been shown.
This E-Learning activity describes clinical relevance of the breast cancer molecular classification and in addition describes a paradigm shift that breast cancer specialists have recently faced in the adjuvant therapy decision: from risk categories based on stage alone to risk categories based on molecular biology and stage. It also provides a framework for determination of tumour responsiveness to a particular therapy.
This E-Learning module was published in 2009 and expired in 2011.
The author has reported no conflicts of interest.