Prognostic signatures are also known as Gene Expression Profiles (GEP) are now commonly used in the clinic to stratify hormone positive breast cancer patients risk of distant recurrence at 10 years and aid treatment strategy decision making. In this blog post, I will review the commonly used GEP and hopefully illustrate their proper clinical utilization as well as limitations. In a previous post, I discussed the adjuvant endocrine therapy for hormone positive breast cancer, for details please click here.
The use of GEP in Early stage breast cancer signficantly reduced the use of Chemotherapy in this patient population.
Continue reading “Prognostic Signatures in Breast Cancer”
The above is an abbreviation of the title of a New England Journal of Medicine (N Engl J Med 2017; 376:2286-91), in this article, the authors discuss identification of a group of tumors that are composed of predominantly overdiagnosed tumors. In order to be clear, I have to start with few definitions.
Overdiagnosis refer to tumors dectected on screening that never would have led to clinical symptoms.
Continue reading “Small tumors are good, or good tumors are small?”
Background: Sentinel lymph node biopsy (SLNB) is now the standard of care used in the staging of the regional lymph nodes in breast cancer. As result of the wide adoption of SLNB attention turned into a detailed examination of the biopsied lymph node(s) and subsequent rise in the incidence of finding lymph node micrometastases. Micrometastases(pN1mi) is defined as a metastatic disease in the lymph node that is less than 2.0 mm but larger than 0.2mm. Isolated tumor cells (ITC) is defined as a metastatic disease in the lymph node that is smaller or equal to 0.2mm. With the rise of incidence of axillary micrometastases, there is a considerable debate on the prognostic significance and appropriate treatment recommendations for such patients.
Continue reading “Micrometastases Mangement”