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Abstract
Biochemical and Biological Markers of Breast Cancer Progression
Highlights
The behaviuor of breast cancer may change during the natural history of the disease, and the tumour heterogeneity allows many factors to influence this[1]
C-ERBB-2 (HER2/NEU GENE) This is more frequently positive in ductal carcinoma in situ (DCIS) than in invasive cancers, in DCIS there is a close association between c-erbB-2 protein expression and high-nucleargrade, comedo types, so it may predict future invasiveness[29]
Socio-economic factor Numerous studies have shown shorter survival times for many diseases in lower compared to higher socioeconomic status groups and in black compared to white breast cancer patients
Summary
The behaviuor of breast cancer may change during the natural history of the disease, and the tumour heterogeneity allows many factors to influence this[1]. The Nottingham prognostic index, a product of primary cancer size, grade and node status, continues to have a higher predictive value than any isolated tumour markers, and the addition of more objective measures such as Sphase may help[2]. S-phase The S-phase fraction (SPF) provides a useful, if crude, independent estimate of the percentage of sells that are undergoing active cell division, and a high Sphase fraction is generally associated with progression[8]. It probably provides a more objective score than unclear grade, which does require some experience. Veronesi et al found that the sentinel node predicted axillary node status accurately in 97.5% (156 of 160) of patients, and in 38% of cases it was the only positive node[9]
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