Li Xiaoxian, Oprea-Ilies Gabriela M, Krishnamurti Uma
From the Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Gerogia.
Arch Pathol Lab Med. 2017 Apr;141(4):490-498. doi: 10.5858/arpa.2016-0288-SA. Epub 2017 Feb 28.
Advances in research have transformed our understanding of breast cancers and have altered the daily practice of pathology. Theranostic evaluations performed by pathologists are now critical in triaging the patients into appropriate treatment groups, as are new guidelines that were recently established for the evaluation of HER2/neu gene amplification. Emerging molecular classifications of breast cancers bring novel perspectives to the assessment of individual cases, and opportunities for better treatments. Molecular studies have particularly shed light on distinct biological subsets of triple-negative breast cancers, for which new targeted therapies are being developed. The prognostic and therapeutic utility of new histopathologic parameters, such as tumor-infiltrating lymphocytes, are also being elucidated, and new protocols have been devised for the pathologic evaluation of breast specimens that have undergone neoadjuvant treatment. Novel clinical practices, such as radioactive seed localization, also affect the way breast specimens are processed and evaluated. In this brief review, we highlight the developments that are most relevant to pathology and are changing or could potentially impact our daily practice.
研究进展改变了我们对乳腺癌的认识，也改变了病理学的日常实践。病理学家进行的治疗诊断评估对于将患者分类到合适的治疗组至关重要，最近制定的评估HER2/neu基因扩增的新指南也是如此。乳腺癌新出现的分子分类为个体病例的评估带来了新视角，以及更好治疗的机会。分子研究特别阐明了三阴性乳腺癌不同的生物学亚群，针对这些亚群正在开发新的靶向治疗方法。新的组织病理学参数（如肿瘤浸润淋巴细胞）的预后和治疗效用也正在得到阐明，并已设计出新的方案用于对接受新辅助治疗的乳腺标本进行病理评估。新型临床实践（如放射性种子定位）也影响着乳腺标本的处理和评估方式。在这篇简短的综述中，我们重点介绍了与病理学最相关、正在改变或可能影响我们日常实践的进展。
