ABSTRACT
The assessment of prognostic factors, in order to provide a prediction of outcome, has become an essential part of the histopathologist’s role in the handling and histological reporting of invasive breast carcinomas.1 Only with this information available can the clinical team select the most appropriate treatment for the management of patients; those with an excellent prognosis can avoid unnecessary adjuvant treatment,2 and women with a very poor prognosis can receive more aggressive therapies. In addition, factors which assist in the identification of patients who may res - pond or be resistant to specific therapies, i.e. predictive factors, can be identified. Such evaluation of predictive factors is an increasing part of the histopathologist’s function and practice. Markers may be examined with techniques such as immunohistochemistry and fluorescence in situ hybridization, and include estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) for prediction of response to hormone agents and tras tuz - umab, respectively (see Chapters 9 and 13). Nevertheless, a large variety of robust and important prognostic features can be assessed using traditional hematoxylin and eosin (H&E) light microscopy. In this chapter, factors are described which have prognostic implications for breast cancer patients and an indication of their relative importance is also described. Table 2.1 indicates some of the range of assessable prognostic factors.
