[Breast cancer: new concepts in classification].

Breast cancer is the principal cause of death from cancer in women. Molecular studies of breast cancer, based in the identification of the molecular profiling techniques through cDNA microarray, had allowed defining at least five distinct sub-group: luminal A, luminal B, HER-2-overexpression, basal and 'normal' type breast-like. The technique of tissue microarrays (TMA), described for the first time in 1998, allows to study, in some samples of breast cancer, distinguished by differences in their gene expression patterns, which provide a distinctive molecular portrait for each tumor and the basis for and improved breast cancer molecular taxonomy. Another important implication is that genetic profiling may lead to the identification of new target for therapy and better predictive markers are needed to guide difficult treatment decisions. Additionally, the current pathology classification system is suboptimal, since patients with identical tumor types and stage of disease present different responses to therapy and different overall outcomes. Basal breast tumor represents one of the most intriguing subtypes and is frequently associated with poor prognosis and absence of putative therapeutic targets. Then, the purpose of this review was to resume the most recent knowledge about the breast carcinoma classification and characterization.

[1]  H. Bando Vascular endothelial growth factor and bevacitumab in breast cancer , 2007, Breast cancer.

[2]  L. Bubendorf,et al.  Tissue microarray analysis reveals prognostic significance of syndecan‐1 expression in prostate cancer , 2003, The Prostate.

[3]  F. Schmitt,et al.  Angiogenesis: now and then , 2004, APMIS : acta pathologica, microbiologica, et immunologica Scandinavica.

[4]  J. Reis-Filho,et al.  Basal-like breast cancer and the BRCA1 phenotype , 2006, Oncogene.

[5]  L. Bégin,et al.  Germline BRCA1 mutations and a basal epithelial phenotype in breast cancer. , 2004, Journal of the National Cancer Institute.

[6]  Jianhua Tao,et al.  Evaluation of Epidermal Growth Factor Receptor (EGFR) by Chromogenic In Situ: Hybridization (CISH™) and Immunohistochemistry (IHC) in Archival Gliomas Using Bright-Field Microscopy , 2004, Diagnostic molecular pathology : the American journal of surgical pathology, part B.

[7]  D. Larsimont,et al.  Chromogenic in situ hybridization: a practical alternative for fluorescence in situ hybridization to detect HER-2/neu oncogene amplification in archival breast cancer samples. , 2000, The American journal of pathology.

[8]  Ronald Simon,et al.  Tissue Microarrays , 2010, Methods in Molecular Biology.

[9]  I. Ellis,et al.  Pathological prognostic factors in breast cancer. , 1999, Critical reviews in oncology/hematology.

[10]  F. Schmitt,et al.  "Basal-like" Breast Carcinomas: Identification by P-cadherin, P63 and EGFR Basal Cytokeratins Expression , 2006 .

[11]  Umberto Veronesi,et al.  Rethinking TNM: breast cancer TNM classification for treatment decision-making and research. , 2006, Breast.

[12]  Van,et al.  A gene-expression signature as a predictor of survival in breast cancer. , 2002, The New England journal of medicine.

[13]  V. Vogel,et al.  Recognition and management of hereditary breast cancer syndromes. , 2004, The oncologist.

[14]  F. Bertucci,et al.  Gene expression profiling of primary breast carcinomas using arrays of candidate genes. , 2000, Human molecular genetics.

[15]  R. Tibshirani,et al.  Repeated observation of breast tumor subtypes in independent gene expression data sets , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[16]  D. Bentley,et al.  Identification of the breast cancer susceptibility gene BRCA2 , 1995, Nature.

[17]  Vessela N Kristensen,et al.  Gene expression profiling of breast cancer in relation to estrogen receptor status and estrogen-metabolizing enzymes: clinical implications. , 2005, Clinical cancer research : an official journal of the American Association for Cancer Research.

[18]  F. Schmitt,et al.  Selecting Antibodies to Detect HER2 Overexpression by Immunohistochemistry in Invasive Mammary Carcinomas , 2006, Applied immunohistochemistry & molecular morphology : AIMM.

[19]  M J O'Hare,et al.  Linking gene expression patterns to therapeutic groups in breast cancer. , 2000, Cancer research.

[20]  Hermann Herbst,et al.  Common Adult Stem Cells in the Human Breast Give Rise to Glandular and Myoepithelial Cell Lineages: A New Cell Biological Concept , 2002, Laboratory Investigation.

[21]  N. Magné,et al.  Pharmacological background of EGFR targeting. , 2004, Annals of oncology : official journal of the European Society for Medical Oncology.

[22]  B. Teh,et al.  The management of familial breast cancer. , 2000, Breast.

[23]  A. Gown,et al.  Immunohistochemical and Clinical Characterization of the Basal-Like Subtype of Invasive Breast Carcinoma , 2004, Clinical Cancer Research.

[24]  O. Kallioniemi,et al.  Tissue microarray technology for high-throughput molecular profiling of cancer. , 2001, Human molecular genetics.

[25]  A. Ashworth,et al.  BRCA1 dysfunction in sporadic basal-like breast cancer , 2007, Oncogene.

[26]  Stefan Michiels,et al.  Gene expression profiling: does it add predictive accuracy to clinical characteristics in cancer prognosis? , 2007, European journal of cancer.

[27]  Yudong D. He,et al.  Gene expression profiling predicts clinical outcome of breast cancer , 2002, Nature.

[28]  Christian A. Rees,et al.  Molecular portraits of human breast tumours , 2000, Nature.

[29]  J. Reis-Filho,et al.  The impact of expression profiling on prognostic and predictive testing in breast cancer , 2006, Journal of Clinical Pathology.

[30]  T. Sørlie,et al.  Distinct molecular mechanisms underlying clinically relevant subtypes of breast cancer: gene expression analyses across three different platforms , 2006, BMC Genomics.

[31]  P. Hall,et al.  Genomic Instability and Prognosis in Breast Carcinomas , 2006, Cancer Epidemiology Biomarkers & Prevention.

[32]  Christian A. Rees,et al.  Distinctive gene expression patterns in human mammary epithelial cells and breast cancers. , 1999, Proceedings of the National Academy of Sciences of the United States of America.

[33]  D. Page,et al.  Routinely available indicators of prognosis in breast cancer , 2004, Breast Cancer Research and Treatment.

[34]  A. Sasco Breast Cancer and the Environment , 2003, Hormone Research in Paediatrics.

[35]  Yonghong Xiao,et al.  Association of BRCA1 with Rad51 in Mitotic and Meiotic Cells , 1997, Cell.

[36]  Ian O Ellis,et al.  Estrogen receptor-negative breast carcinomas: a review of morphology and immunophenotypical analysis , 2005, Modern Pathology.

[37]  J Chang-Claude,et al.  Genetic heterogeneity and penetrance analysis of the BRCA1 and BRCA2 genes in breast cancer families. The Breast Cancer Linkage Consortium. , 1998, American journal of human genetics.

[38]  S. Shak Overview of the trastuzumab (Herceptin) anti-HER2 monoclonal antibody clinical program in HER2-overexpressing metastatic breast cancer. Herceptin Multinational Investigator Study Group. , 1999, Seminars in oncology.

[39]  D. Parkin,et al.  Global cancer statistics in the year 2000. , 2001, The Lancet. Oncology.

[40]  J. Kononen,et al.  Tissue microarrays for high-throughput molecular profiling of tumor specimens , 1998, Nature Medicine.

[41]  D. Hanahan,et al.  The Hallmarks of Cancer , 2000, Cell.

[42]  Luiz Carlos Zeferino,et al.  Carcinoma de mama hereditario em mulheres brasileiras : mutações dos genes BRCA1 e BRCA2, polimorfismos dos genes de reparo do DNA e caracterização imunoistoquimica pela tecnica de Tissue Microarray , 2004 .

[43]  R. Tibshirani,et al.  Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications , 2001, Proceedings of the National Academy of Sciences of the United States of America.

[44]  Steven E. Bayer,et al.  A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. , 1994, Science.

[45]  F. Bertucci,et al.  Sensitivity issues in DNA array-based expression measurements and performance of nylon microarrays for small samples. , 1999, Human molecular genetics.

[46]  Therese Sørlie,et al.  Molecular portraits of breast cancer: tumour subtypes as distinct disease entities. , 2004, European journal of cancer.

[47]  Daniel Birnbaum,et al.  Basal and luminal breast cancers: basic or luminous? (review). , 2004, International journal of oncology.

[48]  M. Salcedo,et al.  A simple method for the construction of small format tissue arrays , 2003, Journal of clinical pathology.

[49]  Carlos Caldas,et al.  Molecular Classification of Breast Carcinomas Using Tissue Microarrays , 2003, Diagnostic molecular pathology : the American journal of surgical pathology, part B.

[50]  J. Cigudosa,et al.  Immunohistochemical characteristics defined by tissue microarray of hereditary breast cancer not attributable to BRCA1 or BRCA2 mutations: differences from breast carcinomas arising in BRCA1 and BRCA2 mutation carriers. , 2003, Clinical cancer research : an official journal of the American Association for Cancer Research.

[51]  Luiz Carlos Zeferino,et al.  Carcinoma de mama: novos conceitos na classificação , 2008 .

[52]  F. Schmitt,et al.  P-cadherin and cytokeratin 5: useful adjunct markers to distinguish basal-like ductal carcinomas in situ , 2006, Virchows Archiv.

[53]  I. Ellis,et al.  The value of histological grade in breast cancer experience from a large study with a long term follow up , 1991 .