Tratamentul personalizat în carcinomul mamar

Abstract

Background: Breast carcinoma represents the most common cancer worldwide and the second main cause of death among women. It’s a complex disease characterized by many morphological, clinical and molecular features. Traditionally, this disease has been classified according to histopathologic criteria, known as the tumor, node and metastasis staging system. Because the classic concept was focusing only on the tumor morphology, it could not fully capture the diversity of the disease. Another classification system, based on hormone receptors and gene expression profiling of different breast cancers types have been developed. This classification dictates the optimal therapeutic approach and it is based on immunohistochemical markers, such as the estrogen receptor, the progesterone receptor, the human epidermal growth factor receptor 2, basal cytokeratin CK5 and proliferation marker Ki67. New technologies, polymerase chain reaction, microarrays make possible identification of new biomarkers involved in breast cancer development, survival and invasion, which can be gradually incorporated into clinical trials. The aim of this study is to highlight the progress achieved in the field of diagnosis and management of breast cancer, using molecular analysis and intrinsic subtypes, commonly accepted in oncology practice. Conclusions: Mammary carcinoma represents heterogenous pathologic entity that is characterised by genetic abnormalities and specific intra/ extracelullar pathways, grouped in intrinsic molecular subtypes identifiable with the help of immunohistochemistry. Modern therapy is based on molecular subtypes; meanwhile their descrimination represents the initial step of personalised treatment.