Breast Cancer Management in the Era of Molecular Medicine: Tailored Radiotherapy — Clinical and Biological Aspects

Abstract

In the era of molecular medicine, the clinical application of molecular and genetic markers in the diagnosis, staging, and management of breast cancer continues to expand rapidly. Immunohistochemical staining techniques allow the pathologist to determine whether tumors express specific proteins. Fig. 13.1 demonstrates positive immunhistochemical staining of estrogen receptor (ER), progesterone receptor (PR), P53 and Her2/neu in breast cancer sections. Although the use of molecular markers as they relate to the tailored use of radiotherapy in local-regional management is only beginning to evolve, there is a growing body of literature supporting the potential for molecular and genetic factors in clinical decision making regarding the application of radiation therapy in the local-regional management of breast cancer. As with conventional clinical and histopathologic factors, data regarding molecular and genetic factors are often conflicting and are subject to the usual limitations of predominantly retrospective studies. There are, however, some consistent 13 Breast Cancer Management in the Era of Molecular Medicine: Tailored Radiotherapy – Clinical and Biological Aspects