Abstract
Current management of breast cancers depends on accurate evaluation of prognostic and predictive tumor markers. The guidelines for evaluation of the commonly used markers, such as estrogen receptor (ER), progesterone receptor (PR), Her2 and proliferation markers are periodically updated. Their clinical significance has been constantly re-evaluated and reinforced by many pre-clinical and clinical research teams. A recent guideline by ASCP/CAP on Her2 interpretation is one of the most recent examples. The importance of tumor heterogeneity and ploidy status of the tumor has become a more and more critical issue in marker interpretation in oncology practice, especially in the evolving disease in recurrence/metastasis. Furthermore, to achieve the personalized treatment, the genomic medicine related assays are a rapidly growing part of breast cancer work-up process, even from a pathology point of view. This short course will discuss the most recent guidelines for the conventional tumor markers, especially Her2 interpretation. The significance of tumor heterogeneity relating to tumor marker interpretation will be discussed, together with tumor ploidy status. In addition, the evolving molecular assays to triage breast cancer patients will be reviewed, including commercially available assays and the genomic tests offered at large academic institutions for targeted therapy.
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