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Breast Cancer Essay

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Introduction
Breast cancer is considered as a heterogeneous disorder whose types are variable biologically and associated with various clinical prognoses and therapeutic responses
(Burstein et al., 2008). Intrinsic molecular variants of breast cancer, namely luminal A, luminal B, HER-2 positive and basal-like, were found in a complementary
DNA microarray study performed on 65 different breast tumors to analyze about 500 genes (Sorlie et al., 2001).
These breast cancer variants were commonly approximated by using routine markers into the followingcategories that possessed various prognoses; luminal A:
ER+ and/or PR+/HER2−; luminal B: ER+ and/or PR+/
HER2+; HER-2 positive: ER−/PR−/HER2+ and basal-like
(basaloid or triple-negative) …show more content…

Many clinical studies of neoadjuvant chemotherapy have established a decreased cancer recurrence rate and a favorable longterm prognosis in patients achieving pCR to neoadjuvant treatment rather than those harboring residual tumor tissues after therapy (Burstein et al., 2008).
Although many clinical trials stated that TNBC possessed a better response to neoadjuvant chemotherapy with higher pCR rate than other breast cancer variants, however, more than fifty percent of patients with TNBC tumors didn’t attain a pCR and demonstrated worse outcomes (Von Minckwitz and Martin, 2012).
The risk of breast cancer recurrence has been predicted by cell proliferation markers (Milde-Langosch et al., 2013). Among these proliferation markers is the nuclear protein Ki-67 that is detected easily by immunohistochemical techniques (Inwald et al., 2013).
All phases of the cell proliferation cycle, apart from G0
(quiescent) phase, express Ki-67 (Gerdes et al., 1991).
Several neoadjuvant series have investigated the predictive and prognostic values of Ki-67 in breast cancer patients.
Breast cancer with high Ki-67 expression, responds better to chemotherapy, but is associated with poor prognosis.
This phenomenon is similar to the triple negative paradox.
In addition, TNBC is associated with a higher expression of Ki-67 than non-TNBC (Keam et al., 2011). However, there was neither standard procedure nor generally

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