Breast cancer classification

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less normal appearing cells that have a worsening prognosis. Although grading is fundamentally based on how biopsied, cultured cells behave, in practice the grading of a given cancer is derived by assessing the cellular appearance of the tumor. The closer the appearance of the cancer cells to normal cells, the slower their growth and the better the prognosis. If cells are not well differentiated, they will appear immature, will divide more rapidly, and will tend to spread. Well differentiated is given a grade of 1, moderate is grade 2, while poor or undifferentiated is given a higher grade of 3 or 4 (depending upon the scale used).

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differentiation. In cancer, the cells that would normally line up in an orderly way to make up the milk ducts become disorganized. Cell division becomes uncontrolled. Cell nuclei become less uniform. Pathologists describe cells as well differentiated (low-grade), moderately differentiated (intermediate-grade), and poorly differentiated (high-grade) as the cells progressively lose the features seen in normal breast cells. Poorly differentiated cancers have a worse prognosis.

2507: 7524: 3352: 2834:(FDA) does not mandate approval of this class of tests if they are performed at a single, company-operated laboratory Genomic Health, which developed Oncotype DX, offers the test under these so-called home brew rules and, accordingly, to that extent the Oncotype DX assay is not specifically FDA approved. 1907:

As a practical matter, reports often use the staging edition that was in place when the study began, rather than the date of acceptance or publication. However, it is worth checking whether the author updated the staging system during the study, or modified the usual classification rules for specific

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M0(i+): Molecularly or microscopically detected tumor cells in circulating blood, bone marrow or non-regional nodal tissue, no larger than 0.2 mm, and without clinical or radiographic evidence or symptoms or signs of metastases, and which, perhaps counter-intuitively, does not change the stage

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Pathologic staging is more accurate than clinical staging, but clinical staging is the first and sometimes the only staging type. For example, if clinical staging reveals stage IV disease, extensive surgery may not be helpful, and (appropriately) incomplete pathological staging information will be

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The grading of a cancer in the breast depends on the microscopic similarity of breast cancer cells to normal breast tissue, and classifies the cancer as well differentiated (low-grade), moderately differentiated (intermediate-grade), and poorly differentiated (high-grade), reflecting progressively

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The purpose of classification is to select the best treatment. The effectiveness of a specific treatment is demonstrated for a specific breast cancer (usually by randomized, controlled trials). That treatment may not be effective in a different breast cancer. Some breast cancers are aggressive and

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Genestie C, Zafrani B, Asselain B, Fourquet A, Rozan S, Validire P, et al. (1998). "Comparison of the prognostic value of Scarff-Bloom-Richardson and Nottingham histological grades in a series of 825 cases of breast cancer: Major importance of the mitotic count as a component of both grading

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is expressed in 80-90% of ER+ breast cancers and 40% of "triple negative" breast cancers. Activation of androgen receptors appears to suppress breast cancer growth in ER+ cancer while in ER- breast it appears to act as growth promoter. Efforts are underway to utilize this as prognostic marker and

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focuses on the appearance of the breast cancer cells compared to the appearance of normal breast tissue. Normal cells in an organ like the breast become differentiated, meaning that they take on specific shapes and forms that reflect their function as part of that organ. Cancerous cells lose that

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have the expected DNA expression profile, and a similar 75% of tumors with a typical basal-like DNA expression profile are receptor TNBC as well. To say this in a different way to emphasize things, this means that 25% of triple-negative breast cancer (TNBC) basal-like tumors as defined by one or

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can increase the risk of breast cancer, and these cancers tend to express a pr ofile of genes, such as p53, in a pattern that has been called "BRCA-ness." Cancers arising from BRCA1 and BRCA2 mutations, as well as other cancers that share a similar "BRCA-ness" profile, including some basal-like

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Leyland-Jones B, Regan MM, Bouzyk M et al. Outcome According to CYP2D6 Genotype among Postmenopausal Women with Endocrine-Responsive Early Invasive Breast Cancer Randomized in the BIG 1-98 Trial. 33rd Annual San Antonio Breast Cancer Symposium (SABCS): abstract S1-8 presented 2010, 9 December;

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rate for both invasive ductal carcinoma and invasive lobular carcinoma was approximately 85% in 2003. Ductal carcinoma in situ, on the other hand, is in itself harmless, although if untreated approximately 60% of these low-grade DCIS lesions will become invasive over the course of 40 years in

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A different effect on staging arises from evolving technologies that are used to assign patients to particular categories, such that increasingly sensitive methods tend to cause individual cancers to be reassigned to higher stages, making it improper to compare that cancer's prognosis to the

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by several different laboratory approaches. When specific DNA mutations or gene expression profiles are identified in the cancer cells this may guide the selection of treatments, either by targeting these changes, or by predicting from these alterations which non-targeted therapies are most

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genes. As might therefore be anticipated, there is considerable similarity between the receptor and microarray classifications, but assignment of individual tumors is by no means identical. By way of illustration, some analyses have suggested that approximately 75% of receptor classified

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Although TNM classification is an internationally agreed system, it has gradually evolved through its different editions; the dates of publication and of adoption for use of AJCC editions is summarized in the table in this article; past editions are available from AJCC for web download.

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Albanell, J.; González, A.; Ruiz-Borrego, M.; Alba, E.; García-Saenz, J. A.; Corominas, J. M.; Burgues, O.; Furio, V.; Rojo, A.; Palacios, J.; Bermejo, B.; Martínez-García, M.; Limon, M. L.; Muñoz, A. S.; Martín, M.; Tusquets, I.; Rojo, F.; Colomer, R.; Faull, I.; Lluch, A. (2011).

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N1mi: Micrometastasis, that is, lymph node clusters at least 2 mm or 200 cells, but less than 2.0 mm. At least one carcinoma focus over 2.0 mm is called "Lymph node metastasis". If one node qualifies as metastasis, all other nodes even with smaller foci are counted as metastases as

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Rae JM, Drury S, Hayes DF et al. Lack of Correlation between Gene Variants in Tamoxifen Metabolizing Enymes with Primary Endpoints in the ATAC Trial. 33rd Annual San Antonio Breast Cancer Symposium (SABCS): abstract S1-7 presented 2010 December 9; accessioned 2010 December 17 at

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Lower-grade tumors, with a more favorable prognosis, can be treated less aggressively, and have a better survival rate. Higher-grade tumors are treated more aggressively, and their intrinsically worse survival rate may warrant the adverse effects of more aggressive medications.

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Xie, Ze-Ming; Sun, Jian; Hu, Zhe-Yu; Wu, Yao-Pan; Liu, Peng; Tang, Jun; Xiao, Xiang-Sheng; Wei, Wei-Dong; Wang, Xi; Xie, Xiao-Ming; Yang, Ming-Tian (2017). "Survival outcomes of patients with lobular carcinoma in situ who underwent bilateral mastectomy or partial mastectomy".

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Although there is considerable evidence that these tests can refine the treatment decisions in a meaningful proportion of breast cancers they are fairly expensive; proposed selection criteria for which particular tumors may benefit by being interrogated by these assays remain

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Various molecular pathway targets and DNA results are being incorporated in the design of clinical trials of new medicines. Specific genes such as p53, NME1, BRCA and PIK3CA/Akt may be associated with responsiveness of the cancer cells to innovative research pharmaceuticals.

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The Nottingham system is recommended for breast cancer grading. The Nottingham system is also called the Bloom–Richardson–Elston system (BRE), or the Elston-Ellis modification of the Scarff-Bloom-Richardson grading system. It grades breast carcinomas by adding up scores for

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New Mexico OncologyHematology Consultants, Ltd. Copyright held by CancerConsultants Breast Cancer Information Center. European Study Reports that Oncotype DX Influences Breast Cancer Treatment Decisions. Posted 2010 October 17, accessioned 2010 Dec 19 and 2, 011 July 3 at

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Mook S, Schmidt MK, Rutgers EJ, van de Velde AO, Visser O, Rutgers SM, et al. (November 2009). "Calibration and discriminatory accuracy of prognosis calculation for breast cancer with the online Adjuvant! program: a hospital-based retrospective cohort study".

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Breast cancers can be classified by different schemata. Each of these aspects influences treatment response and prognosis. Description of a breast cancer would optimally include all of these classification aspects, as well as other findings, such as signs found on

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assesses what percent of the tumor forms normal duct structures. In cancer, there is a breakdown of the mechanisms that cells use to attach to each other and communicate with each other, to form tissues such as ducts, so the tissue structures become less orderly.

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positive disease, the Oncotype test may especially improve the risk assessment that is derived from routine clinical variables in intermediate risk disease. Results from both the US and internationally suggest that Oncotype may assist in treatment decisions.

181:(N) in the armpits, neck, and inside the chest, and whether the tumor has metastasized (M) (i.e. spread to a more distant part of the body). Larger size, nodal spread, and metastasis have a larger stage number and a worse prognosis. The main stages are: 3369: 1922:

values (MX, M0 and M1) which referred respectively to absence of adequate information, the confirmed absence, or the presence of breast cancer cells in locations other than the breast and regional lymph nodes, such as to bone, brain, lung.

6101:"Prospective transGEICAM study of the impact of the 21-gene Recurrence Score assay and traditional clinicopathological factors on adjuvant clinical decision making in women with estrogen receptor-positive (ER+) node-negative breast cancer" 1412:

is the process of determining how much cancer there is in the body and where it is located. The underlying purpose of staging is to describe the extent or severity of an individual's cancer, and to bring together cancers that have similar

3817: 239:. Cells with or without these receptors are called ER positive (ER+), ER negative (ER-), PR positive (PR+), PR negative (PR-), HER2 positive (HER2+), and HER2 negative (HER2-). Cells with none of these receptors are called basal-like or 176:

is based on the size of the cancer where it originally started in the body and the locations to which it has travelled. These cancer characteristics are described as the size of the tumor (T), whether or not the tumor has spread to the

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N0(i+) : Isolated Tumor Cell clusters (ITC), which are small clusters of cells not greater than 0.2 mm, or single tumor cells, or a cluster of fewer than 200 cells in a single histologic cross-section, whether detected by

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Woodward WA, Strom EA, Tucker SL, McNeese MD, Perkins GH, Schechter NR, et al. (September 2003). "Changes in the 2003 American Joint Committee on Cancer staging for breast cancer dramatically affect stage-specific survival".

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where patients who used the test had a better outcome than those who did not. Acquiring extensive Level I evidence would be clinically and ethically challenging. However, several validation approaches are being actively pursued.

1452:, which is a two step procedure. Their TNM system, which they now develop jointly, first classifies cancer by several factors, T for tumor, N for nodes, M for metastasis, and then groups these TNM factors into overall stages. 63:

factors, which estimate disease outcomes such as disease-free or overall survival in the absence of therapy, or true predictive factors, which estimate the likelihood of response or lack of response to a specific treatment.

2885:. The available evidence for Mammaprint was reviewed by California Technology Assessment Forum (CTAF) in June 2010; the written report indicated that MammaPrint had not yet fulfilled all CTAF criteria. MammaPrint has 5 1218: 2521:. Although the significance of many of those genetic differences is unknown, independent analyses by different research groups has found that certain groups of genes have a tendency to co-express. These co-expressing 1112:. It is not applicable to medullary carcinomas which are histologically high-grade by definition, while being clinically low-grade if lymph nodes are negative. It is also not applicable to metaplastic carcinomas. 44:

life-threatening, and must be treated with aggressive treatments that have major adverse effects. Other breast cancers are less aggressive and can be treated with less aggressive treatments, such as lumpectomy.

2715:-positive and triple-negative tumors, but when measures of clinical risk are equivocal (e.g., intermediate expression of ER and intermediate histologic grade), these assays could guide clinical decisions". 1274:

figures (dividing cells) the pathologist sees in 10x high power microscope field. One of the hallmarks of cancer is that cells divide uncontrollably. The more cells that are dividing, the worse the cancer.

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As a result, a given stage may have quite a different prognosis depending on which staging edition is used, independent of any changes in diagnostic methods or treatments, an effect that can contribute to

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and treatment. Staging of breast cancer is one aspect of breast cancer classification that assists in making appropriate treatment choices, when considered along with other classification aspects such as

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Ravdin PM, Siminoff LA, Davis GJ, Mercer MB, Hewlett J, Gerson N, et al. (February 2001). "Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer".

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can present visually appealing graphics that assist in treatment decisions. In addition, other classifications of breast cancers do exist and no uniform system has been consistently adopted worldwide.

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Ruiter R, Bijl MJ, van Schaik RH, Berns EM, Hofman A, Coebergh JW, et al. (October 2010). "CYP2C19*2 polymorphism is associated with increased survival in breast cancer patients using tamoxifen".

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AJCC has provided web accessible poster versions of the current versions of these copyrighted TNM descriptors and groups, and readers should refer to that up to date, accurate information or to the

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Tice JA. The 70-Gene Signature (MammaPrint) as a Guide for the Management of Early Stage Breast Cancer. California Technology Assessment Forum. 2010 June 2nd. Full text accessioned 2010 Dec 19 at

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therapies. Successful validation was seen with Canadian and Dutch cohorts. Adjuvant! seemed less applicable to a British cohort and accordingly PREDICT is being developed in the United Kingdom.

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bind to receptors, and this causes changes in the cell. Breast cancer cells may or may not have many different types of receptors, the three most important in the present classification being:

2003:

treatments of breast cancer. Estrogen receptor positive (ER+) cancer cells depend on estrogen for their growth, so they can be treated with drugs to reduce either the effect of estrogen (e.g.

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Elston, CW; Ellis, IO (1991). "Pathologic prognostic factors in breast cancer. I. The value of histological grades in breast cancer. Experience from a large study with long-term follow-up".

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Staging information that is obtained prior to surgery, for example by mammography, x-rays and CT scans, is called clinical staging and staging by surgery is known as pathological staging.

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Elston CW, Ellis IO. "Pathologic prognostic factors in breast cancer. I. The value of histological grades in breast cancer. Experience from a large study with long-term follow-up".

3020:; this was based on possible differences in the rate of conversion of tamoxifen to the active metabolite, endoxifen. Although some studies had suggested a potential advantage from 1554:), and inside the chest (internal mammary lymph nodes.) The armpit is designated as having three levels: level I is the low axilla, and is below or outside the lower edge of the 2105:

Luminal ER-/AR+: (overlapping with apocrine and so called molecular apocrine) - recently identified androgen responsive subtype which may respond to antihormonal treatment with

379:(WHO) classification of tumors of the breast which includes benign (generally harmless) tumors and malignant (cancerous) tumors, recommends the following pathological types: 3061:

Computer models consider several traditional factors concurrently to derive individual survival predictions and calculations of potential treatment benefits. The validated

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can categorize breast cancers into molecular subtypes that generally correspond to IHC receptor status; one commercial source is the BluePrint test, as discussed in the

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Scatarige JC, Fishman EK, Zinreich ES, Brem RF, Almaraz R (April 1988). "Internal mammary lymphadenopathy in breast carcinoma: CT appraisal of anatomic distribution".

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Correction published at Correction: 6-Thioguanine Selectively Kills BRCA2-Defective Tumors and Overcomes PARP Inhibitor Resistance Cancer Res 2010 October 1;70:7734

6442:"Phase II randomized study of neoadjuvant everolimus plus letrozole compared with placebo plus letrozole in patients with estrogen receptor-positive breast cancer" 2930:

The choice of established chemotherapy medications, if chemotherapy is needed, may also be affected by DNA assays that predict relative resistance or sensitivity.

6717: 6059:"Prospective multicenter study of the impact of the 21-gene recurrence score assay on medical oncologist and patient adjuvant breast cancer treatment selection" 2870:(ER) status. The test is run on formalin fixed, paraffin-embedded tissue. MammaPrint traditionally used rapidly frozen tissue but a room temperature, molecular 859: 4153: 3578:. These are divided by total breast cancer incidence (211,300 invasive and 55,700 in situ cases) as reported from Breast Cancer Facts & Figures 2003–2004 1650:

M1: Distant detectable metastases as determined by classic clinical and radiographic means, and/or metastasis that are histologically larger than 0.2 mm.

1904:. For example, differences in the 1998 and 2003 categories resulted in many cancers being assigned differently, with apparent improvement in survival rates. 6018:"Utility of oncotype DX risk estimates in clinically intermediate risk hormone receptor-positive, HER2-normal, grade II, lymph node-negative breast cancers" 601:(Other well-accepted subtypes of metaplastic mammary carcinoma thought to have clinical significance but not included in the decade old WHO classification: 391: 7002:"An investigation into the performance of the Adjuvant! Online prognostic programme in early breast cancer for a cohort of patients in the United Kingdom" 1546:

values (NX, N0, N1, N2 or N3) depend on the number, size and location of breast cancer cell deposits in various regional lymph nodes, such as the armpit (

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It is crucial to be aware that the TNM system criteria have varied over time, sometimes fairly substantially, according to the different editions that

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Normanno N, De Luca A, Carotenuto P, Lamura L, Oliva I, D'Alessio A (2009). "Prognostic applications of gene expression signatures in breast cancer".

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Several factors are important when reviewing reports for individual breast cancers or when reading the medical literature, and applying staging data.

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For accurate, complete, current details refer to the accessible copyrighted documentation from AJCC, or to the authorized documentation from NCI or

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The impact of different stages on outcome can be appreciated in the following table, taken from patient data in the 2013-2015 period, and using the

526: 5904:

Filho, O. M.; Ignatiadis, M.; Sotiriou, C. (2011). "Genomic Grade Index: An important tool for assessing breast cancer tumor grade and prognosis".

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is usually considered as part of the histological description of a breast cancer, and when present may be associated with more aggressive disease.

5501:"Genomic subtypes of breast cancer identified by array-comparative genomic hybridization display distinct molecular and clinical characteristics" 3325: 2663:

These multigene assays, some partially and some completely commercialized, have been scientifically reviewed to compare them with other standard

5977:"Gene expression profiles in paraffin-embedded core biopsy tissue predict response to chemotherapy in women with locally advanced breast cancer" 6836:

Spears M, Bartlett J (June 2009). "The potential role of estrogen receptors and the SRC family as targets for the treatment of breast cancer".

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Stage III: Invasion into skin and/or ribs, matted lymph nodes, T3N1, T0N2, T1N2, T2N2, T3N2, AnyT N3, T4 any N, locally advanced breast cancer

7261: 7218: 6595: 2609: 7151:"Choosing Treatment for Patients With Ductal Carcinoma In Situ: Fine Tuning the University of Southern California/Van Nuys Prognostic Index" 6797:"Tamoxifen-induced ER-alpha-SRC-3 interaction in HER2 positive human breast cancer; a possible mechanism for ER isoform specific recurrence" 4714: 5552:"Defining the clinical utility of gene expression assays in breast cancer: the intersection of science and art in clinical decision making" 4479: 2789: 2765:

groups, but also suggest that cancers that have a particularly favorable Oncotype DX microarray result tend to derive minimal benefit from

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have released. Readers are assisted by the provision in the table of direct links to the breast cancer chapters of these various editions.

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fixed, paraffin-embedded tissue. Oncotype results are reported as a Recurrence Score (RS), where a higher RS is associated with a worse

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N1: Metastases in 1-3 axillary lymph nodes and/or in internal mammary nodes; and/or in clinically negative internal mammary nodes with

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Harris L, Fritsche H, Mennel R, Norton L, Ravdin P, Taube S, et al. (((American Society of Clinical Oncology))) (November 2007).

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Note: Mitotic figures are counted only at the periphery of the tumor, and counting should begin in the most mitotically active areas.

6170: 4555: 4536: 4517: 4498: 4443: 4341: 6230: 4593: 4574: 2656: 2638: 2613: 2590: 2586: 2582: 1382:

The scores for each of these three criteria are added together to give a final overall score and a corresponding grade as follows:

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DNA-based classification. Understanding the specific details of a particular breast cancer may include looking at the cancer cell

136:, the considerable majority of breast cancers are derived from the epithelium lining the ducts or lobules, and are classified as 5209:"Breast Cancer Special Feature: Comparative oncogenomics identifies breast tumors enriched in functional tumor-initiating cells" 4773: 3696: 7491: 4094: 3305: 3165: 1893: 7102:"BCL2 in breast cancer: a favourable prognostic marker across molecular subtypes and independent of adjuvant therapy received" 3584: 305: 7355: 4444:"American Joint Committee on Cancer: Publications & Electronic Products: Past Editions of the AJCC Cancer Staging Manual" 3720: 3408: 3228: 2808: 2804: 2628: 2624: 1938: 1931: 693: 534: 6268: 4916:"Identification of human triple-negative breast cancer subtypes and preclinical models for selection of targeted therapies" 4192: 2727:

and 5 normal comparator reference genes, and is therefore sometimes known as the 21-gene assay. It was designed for use in

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muscle; level II is the mid-axilla which is defined by the borders of the pectoralis minor muscle; and level III, or high (

4127: 2776:

clinical treatment program that included initial chemotherapy followed by surgery and subsequent additional chemotherapy,

6335: 6211: 4229: 3905:"Histological grading and prognosis in breast cancer; A study of 1409 cases of which 359 have been followed for 15 years" 2992:

affect gene expression in breast cancer and may contribute to some of the observed differences between genetic subtypes.

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is by BluePrint, a commercial-stage 80-gene panel marketed by Agendia, either as a standalone test, or combined with the

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and so it may be appropriate to choose to avoid side effects from that additional treatment. As an additional example, a

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other classification are excluded from the alternative classification's results. Which classification scheme (receptor

1445: 1441: 1108:, each of which is given 1 to 3 points. The scores for each of these three criteria are then added together to give an 709: 146:

is proliferation of cancer cells within the epithelial tissue without invasion of the surrounding tissue. In contrast,

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Since high risk features may already be evident in many high risk cancers, for example hormone-receptor negativity or

20:

into categories according to different schemes criteria and serving a different purpose. The major categories are the

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http://nmcancercenter.org/european-study-reports-that-oncotype-dx%C2%AE-influences-breast-cancer-treatment-decisions/

5888: 3808:"What is the Nottingham combined histologic grade (modified Scarff-Bloom-Richardson grade) system for breast tumors?" 2911:, but internationally the test may be performed if the lymph node status is negative or positive with up to 3 nodes. 2482: 2281: 1464:

values (TX, T0, Tis, T1, T2, T3 or T4) depend on the cancer at the primary site of origin in the breast, as follows:

989: 452: 5838:"American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer" 4150: 2974:(6TG) may overcome the resistance that can arise in BRCA cancers to PARP inhibitors or platinum-based chemotherapy. 7388: 7343: 6016:

Kelly CM, Krishnamurthy S, Bianchini G, Litton JK, Gonzalez-Angulo AM, Hortobagyi GN, et al. (November 2010).

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These results suggest that not only does Oncotype stratify estrogen-receptor positive breast cancer into different

1480: 1069: 1058: 463: 185: 7564: 7559: 5750:"Prediction of adjuvant chemotherapy benefit in endocrine responsive, early breast cancer using multigene assays" 2023:, (in combination with conventional chemotherapy) and this has improved the prognosis significantly. Conversely, 1178:

in the nucleus break down, and irregular nuclei and pleomorphic changes are signs of abnormal cell reproduction.

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are uniform like those in normal breast duct epithelial cells, or whether they are larger, darker, or irregular (

357:, representing about 80% of invasive carcinomas. In the US, 55% of breast cancers are invasive ductal carcinoma. 7251: 3548:"The changing incidence of in situ and invasive ductal and lobular breast carcinomas: United States, 1999–2004" 3045: 1915:

Finally, of course, a further important consideration is the effect of improving treatments over time as well.

6189: 2123:-low: a more recently described class; often triple-negative, but distinct in that there is low expression of 7496: 6592: 2542: 2089: 2024: 240: 151: 6612: 7204: 6246: 3331: 2886: 2831: 2649: 1143:

1 point: tubular formation in more than 75% of the tumor (it may in addition be termed "majority of tumor")

248: 5950: 4885: 2830:. Oncotype fulfilled all California Technology Assessment Forum (CTAF) criteria in October 2006. The U.S. 1987:

Receptor status is a critical assessment for all breast cancers as it determines the suitability of using

7454: 2781: 2598: 2517:

have compared normal cells to breast cancer cells and found differences in the expression of hundreds of

849: 243:. HER2-low has some HER2 proteins on the cell surface, but not enough to be classified as HER2-positive. 7051:"PREDICT: a new UK prognostic model that predicts survival following surgery for invasive breast cancer" 6736:

Hurtado A, Holmes KA, Geistlinger TR, Hutcheson IR, Nicholson RI, Brown M, et al. (December 2008).

5640:

Pharoah PD, Caldas C (November 2010). "Genetics: How to validate a breast cancer prognostic signature".

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Geyer, F. C.; Marchiò, C.; Reis-Filho, J. S. (2009). "The role of molecular analysis in breast cancer".

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N0(mol-): regional lymph nodes have no metastases histologically, but have positive molecular findings (

7514: 7446: 7431: 7383: 7303: 6483:"Epigenetic control of the basal-like gene expression profile via Interleukin-6 in breast cancer cells" 6390:

Issaeva N, Thomas HD, Djureinovic T, Djurenovic T, Jaspers JE, Stoimenov I, et al. (August 2010).

6346:

Alvarez, R. H.; Valero, V.; Hortobagyi, G. N. (2010). "Emerging Targeted Therapies for Breast Cancer".

6334:

Gene Review TOP2A – topoisomerase (DNA) II alpha 170kDa Homo sapiens as Retrieved 18 October 2010

4089: 3160: 1528: 661: 481: 431: 358: 269:

Computer models such as Adjuvant can combine the various classification aspects according to validated

76: 7544: 7378: 7313: 7256: 4367: 3522:

Percentage values are from United States statistics 2004. Subtype specific incidences are taken from

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clearances and is the only FDA cleared microarray assay available. To be eligible for the MammaPrint

1927: 1476: 830: 376: 354: 51:

rely on breast cancer classification to define specific subgroups that are each treated according to

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NCI Cancer Bulletin FDA Update 2007 February 14, Volume 4, Number 7 as Retrieved 17 October 2010 at

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had a worse prognosis, however HER2+ cancer cells respond to drugs such as the monoclonal antibody,

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Dawson SJ, Makretsov N, Blows FM, Driver KE, Provenzano E, Le Quesne J, et al. (August 2010).

3980: 3534: 3523: 3109: 2594: 2485:(FISH) assays. Some commentators prefer this approach, claiming a higher correlation than receptor 2124: 1472: 854: 698: 640: 577: 353:

Invasive carcinoma. This group constitutes the other 70-85%. The most common type in this group is

277: 203: 189: 137: 1123: 7554: 7481: 7278: 7273: 4707: 4441:

American Joint Committee on Cancer. Past Editions of the AJCC Cancer Staging Manual available at

2692: 2529: 2046: 1950: 1167: 572: 558: 404: 212: 52: 6440:

Baselga J, Semiglazov V, van Dam P, Manikhas A, Bellet M, Mayordomo J, et al. (June 2009).

6392:"6-thioguanine selectively kills BRCA2-defective tumors and overcomes PARP inhibitor resistance" 6286:"DNA topoisomerase II alfa expression and the response to primary chemotherapy in breast cancer" 4532:

AJCC Cancer Staging Manual 4th edition; Chapter 25; Breast Cancer – original pages 149-154

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AJCC Cancer Staging Manual 5th edition; Chapter 25; Breast Cancer – original pages 171-180

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AJCC Cancer Staging Manual 6th edition; Chapter 25; Breast Cancer – original pages 223-240

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and presents colored bar charts that display information that may assist in decisions regarding

361:

represent about 10% of invasive carcinomas, and 5% of all breast cancers in the US. The overall

79:(IBC), a form of ductal carcinoma or malignant cancer in the ducts, is distinguished from other 7549: 6915:

Olivotto IA, Bajdik CD, Ravdin PM, Speers CH, Coldman AJ, Norris BD, et al. (April 2005).

5884:

Armen Hareyanon. MapQuant Dx Genomic Grade Test Identifies Breast Cancer Patients. 2 June 2008

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AJCC Cancer Staging Manual 2nd edition; 1983; Chapter 21; Breast Cancer-original pages 127-134

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AJCC Cancer Staging Manual 3rd edition; 1988; Chapter 23; Breast Cancer-original pages 145-150

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positive cancers. One review characterized these genetic tests collectively as adding "modest

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D'Anello L, Sansone P, Storci G, Mitrugno V, D'Uva G, Chieco P, et al. (November 2010).

6284:

MacGrogan G, Rudolph P, Mascarel I, Mauriac L, Durand M, Avril A, et al. (August 2003).

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Jönsson G, Staaf J, Vallon-Christersson J, Ringnér M, Holm K, Hegardt C, et al. (2010).

5358:

Perou CM, Sørlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, et al. (August 2000).

5207:

Herschkowitz JI, Zhao W, Zhang M, Usary J, Murrow G, Edwards D, et al. (February 2012).

5160:"Multigene Classifiers, Prognostic Factors, and Predictors of Breast Cancer Clinical Outcome" 4413: 2996: 2054: 1969: 1551: 1423: 869: 645: 232: 7049:

Wishart GC, Azzato EM, Greenberg DC, Rashbass J, Kearins O, Lawrence G, et al. (2010).

5260:"Genomic analysis identifies unique signatures predictive of brain, lung, and liver relapse" 4914:

Lehmann BD, Bauer JA, Chen X, Sanders ME, Chakravarthy AB, Shyr Y, et al. (July 2011).

4795:

Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CE, Davidson NE, et al. (October 2005).

3254:"Inflammatory breast cancer: Clinical progress and the main problems that must be addressed" 1531:, a clinical circumstance where typical skin changes involve at least a third of the breast. 6749: 6545: 5371: 3089: 3029: 3003:(LRP6) may represent a distinct subtype of breast cancer and a potential treatment target. 2871: 2551: 2486: 2293: 2008: 1958: 1579: 940: 905: 814: 726: 519: 495: 6668:"Predictive relevance of HOXB13 protein expression for tamoxifen benefit in breast cancer" 6534:"LRP6 overexpression defines a class of breast cancer subtype and is a target for therapy" 6167: 4552: 4533: 4514: 4495: 4447: 4333: 4313: 3611:"Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome" 2558:) more reliably assorts particular cancers to effective therapies is under investigation. 8: 6264:

Introducing BluePrint: A Molecular Subtyping Profile for Breast Cancer. Agendia web site.

4844:

Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, et al. (August 2007).

4282:"Internal mammary lymphadenopathy: imaging of a vital lymphatic pathway in breast cancer" 2824: 1017: 968: 656: 635: 630: 71:

appearance of tissue in the tumor. A variant from this approach, defined on the basis of

6753: 6549: 6227: 5375: 4590: 4571: 2904:

positive (ER+) or estrogen receptor negative (ER-). In the US, the tumor should also be

2811:(NCCN). The NCCN Panel considers the 21-gene assay as an option when evaluating certain 2027:(i.e. no positive receptors), lacking targeted treatments, now has a comparatively poor 87:

appearance of the affected breast, which correlates with increased cancer aggressivity.

7441: 7177: 7150: 7126: 7101: 7077: 7050: 7026: 7001: 6946: 6917:"Population-based validation of the prognostic model ADJUVANT! for early breast cancer" 6861: 6772: 6694: 6667: 6568: 6533: 6509: 6482: 6416: 6391: 6312: 5862: 5837: 5721: 5665: 5617: 5592: 5527: 5500: 5481: 5438: 5395: 5340: 5284: 5259: 5235: 5189: 5091: 5043: 5018: 4989: 4964: 4940: 4915: 4826: 4708:"National Comprehensive Cancer Network (NCCN) guidelines, Breast Cancer Version 2.2011" 4396: 4369: 4298: 4281: 4208: 3929: 3904: 3843:, Schraml P, Torhorst J, Tapia C, Zaharieva B, Novotny H, et al. (December 2004). 3788: 3761: 3749: 3688: 3661: 3459: 3434: 2537: 2463: 1742: 1449: 1258: 791: 688: 513: 476: 468: 325: 166: 6978: 5766: 5749: 3637: 3610: 3280: 3253: 2819:, emphasizing that the recurrence score should be used along with other breast cancer 7182: 7131: 7082: 7031: 6982: 6938: 6897: 6853: 6818: 6777: 6699: 6648: 6573: 6514: 6463: 6421: 6363: 6317: 6122: 6080: 6039: 5998: 5921: 5917: 5867: 5815: 5771: 5713: 5657: 5622: 5573: 5532: 5473: 5430: 5387: 5344: 5332: 5324: 5307:

Tsang, Julia Y.S.; Tse, Gary M. (2020). "Molecular Classification of Breast Cancer".

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panel marketed by Agendia, that was developed in patients under age 55 years who had

2731: 2645: 2620: 2387: 2050: 2034: 1965: 1746: 1419: 802: 441: 228: 142: 7167: 6950: 6865: 5975:

Gianni L, Zambetti M, Clark K, Baker J, Cronin M, Wu J, et al. (October 2005).

5792:

Fan C, Oh DS, Wessels L, Weigelt B, Nuyten DS, Nobel AB, et al. (August 2006).

5725: 5708: 5691: 5669: 5485: 5193: 5095: 4370:"Five-year relative survival by stage of breast and colon cancers in northern Italy" 4258: 4040:

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3765: 3450: 3302: 2466:. In contrast, modern DNA analyses are increasingly relevant in defining underlying 1745:

for staging. It does not show the influence of important additional factors such as

1566:

N0: There is some nuance to the official definitions for N0 disease, which includes:

7172: 7162: 7121: 7113: 7072: 7062: 7021: 7013: 6974: 6928: 6889: 6845: 6808: 6767: 6757: 6689: 6679: 6640: 6563: 6553: 6504: 6494: 6453: 6411: 6403: 6355: 6307: 6297: 6112: 6070: 6057:

Lo SS, Mumby PB, Norton J, Rychlik K, Smerage J, Kash J, et al. (April 2010).

6029: 5988: 5913: 5857: 5849: 5805: 5761: 5703: 5649: 5612: 5604: 5563: 5522: 5512: 5465: 5442: 5422: 5399: 5379: 5316: 5279: 5271: 5230: 5220: 5171: 5127: 5075: 5038: 5030: 4984: 4976: 4935: 4927: 4857: 4830: 4808: 4757: 4654: 4618: 4609:

Feinstein, A. R.; Sosin, D. M.; Wells, C. K. (1985). "The Will Rogers Phenomenon".

4391: 4381: 4293: 4254: 4124: 4053: 3924: 3916: 3856: 3845:"Prognostic relevance of gene amplifications and coamplifications in breast cancer" 3780: 3745: 3683: 3673: 3632: 3622: 3559: 3486: 3454: 3446: 3275: 3265: 3216: 3138: 2931: 2746:, referring to the likelihood of recurrence without treatment. In addition to that 2231: 1988: 1555: 1283: 1007: 751: 343: 317: 67:

Classification of breast cancer is usually, but not always, primarily based on the

6407: 4980: 4862: 4845: 4589:

AJCC Cancer Staging Manual 1977; Chapter 12; Breast Cancer-original pages 101-108

3861: 3844: 3564: 3547: 313: 40:. As knowledge of cancer cell biology develops these classifications are updated. 7528: 7415: 7402: 7350: 6738:"Regulation of ERBB2 by oestrogen receptor-PAX2 determines response to tamoxifen" 6619: 6599: 6272: 6265: 6253: 6234: 6215: 6196: 6174: 6148: 5892: 5320: 5176: 5159: 5034: 4965:"Androgen receptor expression and breast cancer survival in postmenopausal women" 4597: 4578: 4559: 4540: 4521: 4502: 4483: 4233: 4157: 4131: 3700: 3394: 3309: 3074: 2985: 2982:

may show more effect in PIK3CA/Akt e9 mutants than in e20 mutants or wild types.

2963: 2566: 2555: 2522: 2514: 2077: 1597: 951: 418: 362: 347: 5690:

Ross, J. S.; Hatzis, C.; Symmans, W. F.; Pusztai, L.; Hortobagyi, G. N. (2008).

4622: 4176: 4151:

http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional/page3

3220: 2573:

and may help decide which possible treatment is most effective for a particular

7461: 7370: 7330: 5653: 5258:

Harrell JC, Prat A, Parker JS, Fan C, He X, Carey L, et al. (April 2012).

4963:

Hu R, Dawood S, Holmes MD, Collins LC, Schnitt SJ, Cole K, et al. (2011).

3490: 3215:. Advances in Experimental Medicine and Biology. Vol. 608. pp. 1–22. 3024:

testing, data from two large clinical trials found no benefit. Testing for the

3007: 2890: 2878: 2676: 2562: 2431: 1977: 1901: 1562:) axilla which is above the pectoralis minor muscle. Each stage is as follows: 1409: 1047: 766: 563: 488: 309:

Histopathologic types of breast cancer, with relative incidences and prognoses.

170: 133: 21: 6893: 6849: 6208: 5359: 5275: 5079: 4368:

Mangone L, Marinelli F, Bisceglia I, Braghiroli MB, Damato A, Pinto C (2022).

4226: 2785: 2750:

role, a higher RS is also associated with a higher probability of response to

2605:

Numerous genetic profiles have been developed. The most heavily marketed are:

1976:. This remains the most common method of testing for receptor status, but DNA 290:

Familial breast cancers may potentially undergo dissimilar treatment (such as

7538: 7266: 7241: 7227: 6666:

Jerevall PL, Jansson A, Fornander T, Skoog L, Nordenskjöld B, Stål O (2010).

6458: 6441: 6359: 6075: 6058: 5993: 5976: 5853: 5608: 5568: 5551: 5328: 4846:"Triple-negative breast cancer: clinical features and patterns of recurrence" 4386: 4067: 4058: 4041: 3541: 3530: 3498: 3418: 3356: 3028:

polymorphism gave counterintuitive results. The medical utility of potential

2971: 2915: 2857: 2578: 2069: 1954: 339: 102: 72: 17: 6933: 6916: 6558: 6499: 6117: 6100: 5225: 5208: 4658: 4090:"Infiltrating Ductal Carcinoma of the Breast (Carcinoma of No Special Type)" 3161:"Infiltrating Ductal Carcinoma of the Breast (Carcinoma of No Special Type)" 1149:

3 points: tubular formation in less than 10% of the tumor ("little or none")

283:

The choice of which treatment to receive can be substantially influenced by

7410: 7186: 7135: 7117: 7086: 7035: 7017: 6986: 6942: 6901: 6857: 6822: 6781: 6703: 6652: 6577: 6518: 6467: 6425: 6367: 6321: 6302: 6285: 6126: 6084: 6043: 6002: 5925: 5871: 5819: 5775: 5717: 5692:"Commercialized Multigene Predictors of Clinical Outcome for Breast Cancer" 5661: 5626: 5577: 5536: 5477: 5434: 5391: 5336: 5293: 5244: 5185: 5141: 5087: 5052: 4998: 4949: 4871: 4822: 4769: 4666: 4405: 4188: 4075: 3938: 3870: 3646: 3573: 3546:

Eheman CR, Shaw KM, Ryerson AB, Miller JW, Ajani UA, White MC (June 2009).

3506: 3468: 3289: 3238: 3208:"Overview of Resistance to Systemic Therapy in Patients with Breast Cancer" 3070: 2863:. The commercial test is marketed for use in breast cancer irrespective of 2816: 2777: 2769: 2751: 2106: 2049:

status was traditionally considered by reviewing each individual receptor (

1575: 1426:

levels in the cancer tissue, the human epidermal growth factor receptor 2 (

1163: 1002: 781: 756: 741: 731: 703: 683: 273:

and present visually appealing graphics that assist in treatment decisions.

220: 84: 68: 55:. Classification aspects must be carefully tested and validated, such that 6593:

http://www.abstracts2view.com/sabcs10/view.php?nu=SABCS10L_1093&terms=

6190:

http://www.cancer.gov/aboutnci/ncicancerbulletin/archive/2007/021407/page5

5885: 4761: 4630: 4307: 4266: 3966: 3757: 3713:

World Health Organization: Tumours of the Breast and Female Genital Organs

2874:

is available for use within 60 minutes of obtaining fresh tissue samples.

1647:

grouping, as staging for in M0(i+) is done according to the T and N values

7486: 6613:

http://www.abstracts2view.com/sabcs10/view.php?nu=SABCS10L_556&terms=

5810: 5793: 5413:

Nagasaki K, Miki Y (2006). "Gene expression profiling of breast cancer".

4813: 4797:"Trastuzumab plus adjuvant chemotherapy for operable HER2+ breast cancer" 4796: 4746:"Molecular origin of cancer: gene-expression signatures in breast cancer" 4042:"Grading systems in the cytological diagnosis of breast cancer: A review" 2989: 2935: 2773: 2700: 2490: 2462:

power was less substantial than other classification schemes such as the

2020: 1996: 841: 746: 719: 589: 320:

and lobules, the locations of ductal and lobular carcinoma, respectively.

284: 178: 56: 7148: 6813: 6796: 6762: 6737: 6247:

http://www.agendia.com/pages/patient_eligibility_internationally/317.php

4475:

AJCC Cancer Staging Manual, 7th edition, updated Cancer Staging Posters.

3920: 3204: 3112:(DCIS) into dissimilar risk categories that may be treated accordingly. 7308: 6644: 6034: 6017: 5593:"Predictive biomarker validation in practice: lessons from real trials" 3606:

NOTE: Number really refers to invasive ductal carcinoma, despite title.

2979: 2962:

receptor triple negative breast cancers, may respond to treatment with

2919: 2905: 2882: 2853: 2843: 2762: 2755: 2747: 2708: 2704: 2634: 2510:

Molecular classification of breast cancer from mRNA expression profiles

2459: 2455: 2132: 2128: 2061:) in turn, but newer approaches look at these together, along with the 1919: 1543: 1175: 736: 678: 592: 585: 567: 552: 549: 542: 411: 324:

Histopathologic classification is based upon characteristics seen upon

291: 280:(DCIS) into dissimilar risk categories that may be treated accordingly. 199: 5794:"Concordance among gene-expression-based predictors for breast cancer" 5498: 5469: 5426: 4123:

What is Cancer Staging? American Joint Committee on Cancer 2010 May 5.

1753:

receptor status, and does not reflect the impact of newer treatments.

5383: 4931: 3093: 3062: 3017: 2743: 2439: 2073: 2028: 2012: 2004: 1992: 1414: 1387: 1267: 1159: 1132: 1052: 1037: 1022: 956: 875: 787: 761: 506: 499: 270: 216: 80: 60: 48: 7067: 6795:

Mc Ilroy M, Fleming FJ, Buggy Y, Hill AD, Young LS (December 2006).

6684: 6245:

MammaPrint Patient Eligibility Internationally (Outside of the USA)

5517: 3144:

Olympus BX50, BX40 or BH2 or AO or Nikon with 15x eyepiece: 0.096 mm

2506: 1559: 3812: 3678: 3627: 3270: 3077: 3041: 2967: 2898: 2864: 2766: 2739: 2728: 2642: 2617: 2493:, a targeted therapy, but guidelines permit either testing method. 2478: 2112: 2000: 1962: 1750: 1427: 962: 932: 926: 920: 914: 911: 899: 650: 472: 236: 6389: 2815:

to assist in estimating likelihood of recurrence and benefit from

1146:

2 points: tubular formation in 10 to 75% of the tumor ("moderate")

6735: 6480: 6015: 3355:

This article incorporates text from this source, which is in the

3025: 3013: 2939: 2526: 2447: 2435: 2120: 1271: 1030: 946: 797: 671: 334: 251:(FDA) targeted to people with the HER2-low breast cancer subtype. 224: 33: 7196: 6439: 6097: 3326:"FDA Approves First Targeted Therapy for HER2-Low Breast Cancer" 1393:

6-7 Grade 2 tumor (moderately differentiated). Medium prognosis.

1193:

1 point: nuclei with minimal or mild variation in size and shape

1139:

Note: The overall appearance of the tumor has to be considered.

6283: 5455: 4743: 4149:

National Cancer Institute. Stage Information for Breast Cancer.

3951: 3033: 3021: 3006:

Numerous clinical investigations looked at whether testing for

2943: 2574: 2467: 2451: 1586: 1547: 1186: 1182: 1012: 714: 7048: 6963: 6201: 2072:

into several conceptual molecular classes that have different

1643:

M0: No clinical or radiographic evidence of distant metastases

1430:) status, menopausal status, and the person's general health. 1236:

Invasive lobular carcinoma with moderate nuclear pleomorphism.

820:

Metastatic tumors to the breast from other places in the body

6665: 4477:

http://www.cancerstaging.org/staging/posters/breast8.5x11.pdf

4174: 3839: 3205:

Gonzalez-Angulo AM, Morales-Vasquez F, Hortobagyi GN (2007).

2955: 2951: 2893:, a breast cancer should have the following characteristics: 2812: 2796: 2735: 2684: 2546: 2093: 2062: 1461: 1224:

Invasive ductal carcinoma with moderate nuclear pleomorphism.

624: 458: 5116:"Molecular Stratification of Triple-Negative Breast Cancers" 4244: 2970:. Combining these newer medicines with older agents such as 7000:

Campbell HE, Taylor MA, Harris AL, Gray AM (October 2009).

5357: 4039: 3662:"Ductal carcinoma in situ (DCIS): are we overdetecting it?" 3097: 3037: 3016:

of several genes could predict whether or not to prescribe

3000: 2975: 2925: 2849: 2827: 2724: 2712: 2688: 2680: 2570: 2533: 2518: 2443: 2058: 2016: 1973: 1889: 1396:

8-9 Grade 3 tumor (poorly differentiated). Worst prognosis.

1248:

Invasive ductal carcinoma with marked nuclear pleomorphism.

1171: 37: 7099: 6914: 6532:

Liu, C. -C.; Prior, J.; Piwnica-Worms, D.; Bu, G. (2010).

5835: 5206: 4886:"Understanding and Treating Triple-Negative Breast Cancer" 4643: 1196:

2 points: nuclei with moderate variation in size and shape

328:

of biopsy specimens. They can broadly be classified into:

132:

Histopathology. Although breast cancer has many different

6878: 6630: 5019:"Deconstructing the molecular portraits of breast cancer" 4843: 3581:"ACS :: Breast Cancer Facts & Figures 2003-2004" 2434:

was based on the general observation that cells that are

2428: 259: 255: 195:

Stages 1–3 are within the breast or regional lymph nodes.

188:. Stage 0 is a pre-cancerous or marker condition, either 6999: 6794: 6226:

Ordering Symphony is a simple process. Agendia web site.

5974: 5743: 5689: 3608: 2938:

is relatively useful. Expression of genes that regulate

2319:

Progesterone receptor positive in less than 20% of cases

2076:

and may have different responses to specific therapies.

1199:

3 points: nuclei with marked variation in size and shape

124:, and the presence or absence of genes as determined by 6531: 6345: 6220: 6168:

http://www.ctaf.org/content/assessments/detail/?id=1178

5903: 4913: 4553:

http://www.cancerstaging.org/products/csmanual3ed_2.pdf

4534:

http://www.cancerstaging.org/products/csmanual4ed_2.pdf

4515:

http://www.cancerstaging.org/products/csmanual5ed_4.pdf

4496:

http://www.cancerstaging.org/products/csmanual6ed-4.pdf

4314:

http://radiographics.rsna.org/content/10/5/857.full.pdf

4312:

available as full text article with multiple images at

3545: 2303:

Progesterone receptor positive in at least 20% of cases

1961:(IHC), which stains the cells based on the presence of 437:

Classic Solid Mixed Alveolar Tubulolobular Pleomorphic

6720:. CORDIS : News. 13 November 2008. Archived from 5065: 4794: 4279: 4227:

Creative Commons Attribution 4.0 International License

2593:, which is rigorously defined as being derived from a 1999:. These treatments are now some of the most effective 7512: 6228:

http://www.agendia.com/pages/ordering_symphony/38.php

4962: 4702: 4700: 4698: 4696: 4591:

http://www.cancerstaging.org/products/csmanual1ed.pdf

4572:

http://www.cancerstaging.org/products/csmanual2ed.pdf

4280:

Scatarige JC, Boxen I, Smathers RL (September 1990).

2848:

The MammaPrint gene pattern is a commercial-stage 70-

6056: 5257: 4694: 4692: 4690: 4688: 4686: 4684: 4682: 4680: 4678: 4676: 4331: 3439:

Journal of the National Cancer Institute. Monographs

3108:

The USC/Van Nuys prognostic index (VNPI) classifies

619:

Metaplastic carcinoma with osteoclastic giant cells)

276:

The USC/Van Nuys prognostic index (VNPI) classifies

5791: 4608: 3896: 2914:One method of assessing the molecular subtype of a 2623:(ER) positive tumors, and has been endorsed by the 2450:. These methods, and scoring systems that used DNA 2140:Comparison of molecular subtypes of breast cancer. 1600:, or macrometastasis on sentinel lymph node biopsy. 457:Mucinous carcinoma and other tumours with abundant 3609:Arpino G, Bardou VJ, Clark GM, Elledge RM (2004). 3362: 3251: 3206: 3083: 3051: 3001:low-density lipoprotein receptor-related protein 6 150:invades the surrounding tissue. Perineural and/or 7149:Silverstein Melvin J., Lagios Michael D. (2010). 6380:Tutt A J Clin Onc 2009; 27(suppl 15): abst CRA501 6239: 4673: 4119: 4117: 2536:-related genes, a group of basal-like genes, and 2422: 2339:HER2, estrogen and progesterone receptor negative 2080:have assisted this approach, as discussed in the 1934:sites which reprints these with AJCC permission. 7536: 6258: 6162: 6160: 6158: 6156: 5590: 5200: 4125:http://www.cancerstaging.org/mission/whatis.html 4033: 1680:Breast cancer prognosis by stage 1212:Ductal carcinoma with mild nuclear pleomorphism. 6718:"Study sheds new light on tamoxifen resistance" 6538:Proceedings of the National Academy of Sciences 5213:Proceedings of the National Academy of Sciences 4362: 4360: 4169: 4167: 4165: 3902: 3883: 2442:, and relied on either the presence of protein 1127:Tubule formation score in the Nottingham system 346:programs. These have favorable prognosis, with 6835: 6266:http://www.agendia.com/pages/blueprint/324.php 6184: 6182: 4909: 4907: 4114: 3401:Robbins and Cotran pathologic basis of disease 3320: 3318: 1386:3-5 Grade 1 tumor (well-differentiated). Best 7212: 6153: 5932: 5878: 5831: 5829: 5739: 5737: 5735: 5639: 5360:"Molecular portraits of human breast tumours" 3383: 3381: 3379: 3377: 2175:Compared to Luminal A, higher expression of: 1981: 342:, more so in countries with high coverage of 7093: 7042: 6993: 6957: 6908: 6872: 6829: 6788: 6474: 6383: 6091: 6009: 5968: 5633: 5584: 5549: 5543: 5492: 5449: 5412: 5406: 5351: 5300: 5109: 5107: 5105: 4637: 4418:: CS1 maint: multiple names: authors list ( 4357: 4162: 4145: 4143: 4141: 4139: 3945: 3103: 3040:, and estrogen receptor (ER) alpha and beta 2088:Basal-like: ER-, PR- and HER2-; also called 1615:N2: Fixed/matted ipsilateral axillary nodes. 6339: 6209:http://www.agendia.com/pages/mission/86.php 6179: 5685: 5683: 5681: 5679: 5251: 5153: 5151: 5012: 5010: 5008: 4904: 4602: 4471: 4469: 4467: 4465: 4327: 4325: 4323: 4321: 4273: 4238: 4046:Journal of Cancer Research and Therapeutics 3735: 3432: 3315: 3198: 3150:Nikon or Olympus with 10x eyepiece: 0.16 mm 2837: 2784:found a strong correlation of the Oncotype 2648:(ER) positive and negative tumors, and has 2332:Estrogen and progesterone receptor negative 1537: 1110:overall final score and corresponding grade 449:(also termed invasive cribriform carcinoma) 447:Invasive cribriform carcinoma of the breast 192:(DCIS) or lobular carcinoma in situ (LCIS). 7219: 7205: 6207:The mission of Agendia. Agendia web isite. 5826: 5787: 5785: 5732: 4739: 4737: 4735: 3715:. Oxford : Oxford University Press. 2003. 3518: 3516: 3475: 3435:"Epidemiology of ductal carcinoma in situ" 3374: 3100:has shown promise in preliminary studies. 2897:1 or 2, tumor size less than 5.0 cm, 2470:biology and in helping choose treatments. 2131:and frequently there is infiltration with 1170:). In cancer, the mechanisms that control 7262:Hereditary breast–ovarian cancer syndrome 7176: 7166: 7125: 7076: 7066: 7025: 6932: 6812: 6771: 6761: 6693: 6683: 6567: 6557: 6508: 6498: 6457: 6415: 6311: 6301: 6116: 6074: 6033: 5992: 5897: 5861: 5809: 5765: 5707: 5616: 5591:Mandrekar SJ, Sargent DJ (October 2010). 5567: 5526: 5516: 5283: 5234: 5224: 5175: 5131: 5102: 5059: 5042: 5016: 4988: 4939: 4861: 4812: 4437: 4435: 4433: 4431: 4429: 4395: 4385: 4297: 4136: 4057: 3928: 3860: 3687: 3677: 3636: 3626: 3563: 3458: 3279: 3269: 2616:, and was originally designed for use in 2454:, are used much less often now, as their 2015:. Generally, prior to modern treatments, 1659:A combination of T, N and M, as follows: 1637: 1101: 616:Squamous cell carcinoma of mammary origin 338:. This group constitutes about 15-30% of 5676: 5306: 5148: 5005: 4744:Sotirou Christos, Pusztai Lajos (2009). 4583: 4564: 4545: 4526: 4507: 4488: 4462: 4318: 4175:Fadi M. Alkabban; Troy Ferguson (2021). 3805: 2926:Other DNA assays and choice of treatment 2505: 2446:or the percentage of cancer cell DNA in 2111:ERBB2/HER2-amplified: has overexpressed 2007:) or the actual level of estrogen (e.g. 1912:historical expectations for that stage. 1736: 1669:Stage II: T2N0, T3N0 T0N1, T1N1, or T2N1 1628:N3b – Ipsilateral internal mammary nodes 1257: 1122: 312: 304: 247:is the first approved therapy by the US 6525: 5940:"Select your country: Qiagen Marseille" 5906:Critical Reviews in Oncology/Hematology 5886:http://www.emaxhealth.com/98/22731.html 5782: 4956: 4732: 4332:Joseph A Sparano, MD (6 October 2021). 3513: 3403:. Philadelphia, PA: Saunders/Elsevier. 3398: 3368:References for pie chart is located at 2723:Oncotype DX assesses 16 cancer-related 2084:. Proposed molecular subtypes include: 1631:N3c – Ipsilateral supraclavicular nodes 1625:N3a – Ipsilateral infraclavicular nodes 1153: 125: 59:are minimized, making them either true 7537: 7492:National Breast Cancer Awareness Month 6050: 4426: 4344:from the original on 13 September 2020 4102:from the original on 11 September 2019 4095:Stanford University School of Medicine 3903:Bloom, H.J.; Richardson, W.W. (1957). 3173:from the original on 11 September 2019 3166:Stanford University School of Medicine 3133: 3131: 3129: 3127: 3125: 2792:(CR) to the presurgical chemotherapy. 2268:Pleomorphic invasive lobular carcinoma 2258:Pleomorphic invasive lobular carcinoma 7200: 5113: 4195:from the original on 24 December 2020 4021:from the original on 8 September 2020 4011:"Metaplastic Carcinoma of the Breast" 3991:from the original on 8 September 2020 3820:from the original on 30 November 2020 3659: 2809:National Comprehensive Cancer Network 2805:American Society of Clinical Oncology 2803:Oncotype DX has been endorsed by the 2625:American Society of Clinical Oncology 2417: 2199:High expression of HER2-related genes 1957:has traditionally been identified by 1932:National Comprehensive Cancer Network 1185:areas having cells with the greatest 1115:The grading criteria are as follows: 1097: 694:Pseudoangiomatous stromal hyperplasia 535:Pure apocrine carcinoma of the breast 370: 90: 16:Breast cancer classification divides 5264:Breast Cancer Research and Treatment 5157: 3032:of tamoxifen responsiveness such as 2934:(TOP2A) expression predicts whether 2881:using MammaPrint is included in the 2672: 2275:High grade invasive ductal carcinoma 2265:High grade invasive ductal carcinoma 2081: 2041: 1756: 1675:Stage IV: M1, advanced breast cancer 1455: 1262:Mitosis appearances in breast cancer 382: 184:Stage 0 which is in situ disease or 121: 32:of the tumor, and the expression of 5550:Sparano JA, Solin LJ (April 2010). 4801:The New England Journal of Medicine 4776:from the original on 5 January 2010 4750:The New England Journal of Medicine 3981:"Medullary Carcinoma of the Breast" 3252:Giordano SH, Hortobagyi GN (2003). 3122: 2242:Low grade invasive ductal carcinoma 2102:Luminal B: ER+ but often high grade 2096:breast cancers are basal-like TNBC. 1941:; for past editions refer to AJCC. 1118: 794:section on types of breast cancer) 106: 13: 4720:from the original on 24 March 2009 4299:10.1148/radiographics.10.5.2217975 3750:10.1111/j.1365-2559.1991.tb00229.x 3340:from the original on 6 August 2022 3303:Merck Manual, Professional Edition 3056: 3048:have all yet to be fully defined. 2496: 2245:Classic invasive lobular carcinoma 2202:Low expression of ER-related genes 1944: 1446:International Union Against Cancer 1442:American Joint Committee on Cancer 1109: 1105: 837:Intraductal proliferative lesions 710:Inflammatory myofibroblastic tumor 399:The remainder are given subtypes: 396:Most are "not otherwise specified" 14: 7576: 7502:List of people with breast cancer 7226: 4920:Journal of Clinical Investigation 3552:Cancer Epidemiol. Biomarkers Prev 3474:Lobular carcinoma in situ: 97% - 3370:Image description page in commons 2942:may help predict the activity of 2589:. No tests have been verified by 2483:fluorescent in-situ hybridization 1918:Previous editions featured three 1468:TX: inability to assess that site 860:Apocrine ductal carcinoma in situ 531:Invasive micropapillary carcinoma 453:Medullary carcinoma of the breast 424:Carcinoma with melanotic features 300: 266:Other classification approaches. 105:. A full classification includes 7522: 7389:Hereditary lobular breast cancer 7384:Invasive lobular carcinoma (ILC) 7379:Lobular carcinoma in situ (LCIS) 7142: 6611:accessioned 2010 December 17 at 5918:10.1016/j.critrevonc.2010.01.011 5133:10.1634/theoncologist.2011-S1-61 4892:from the original on 9 June 2010 3785:10.1046/j.1365-2559.2002.14892.x 3431:Ductal carcinoma in situ: 99% - 3350: 3336:(Press release). 5 August 2022. 3092:tests that may further stratify 2683:, they seem to classify a given 2386:HER2 amplicon and corresponding 1654: 1377: 1253: 1241: 1229: 1217: 1205: 539:Apocrine-like invasive carcinoma 464:Mucinous carcinoma of the breast 7437:Metaplastic breast cancer (MBC) 7356:Invasive ductal carcinoma (IDC) 7339:Ductal carcinoma in situ (DCIS) 6710: 6659: 6624: 6604: 6584: 6433: 6374: 6328: 6277: 6133: 5798:New England Journal of Medicine 5709:10.1634/theoncologist.2007-0248 5017:Prat, A.; Perou, C. M. (2011). 4878: 4837: 4788: 4611:New England Journal of Medicine 4259:10.1148/radiology.167.1.3347753 4082: 4003: 3973: 3877: 3833: 3799: 3729: 3705: 3653: 3084:Other immunohistochemical tests 3052:Other classification approaches 2655:Two other tests also only have 2011:), and generally have a better 1065:Malignant tumors of the nipple 889:Intracystic papillary carcinoma 886:Intraductal papillary carcinoma 870:Intraductal papillary neoplasms 206:has a less favorable prognosis. 117: 5309:Advances in Anatomic Pathology 5164:Advances in Anatomic Pathology 3599: 3425: 3296: 3245: 3213:Breast Cancer Chemosensitivity 2718: 2711:information for patients with 2561:Several commercially marketed 2543:triple-negative breast cancers 2423:Traditional DNA classification 2409:PI3K/AKT pathway oversignaling 2210:Basal epithelial-related genes 1978:multi-gene expression profiles 670:Mesenchymal tumors (including 223:. Chemical messengers such as 215:on their surface and in their 1: 7497:Epidemiology of breast cancer 7344:Paget's disease of the breast 7168:10.1093/jncimonographs/lgq040 6979:10.1016/S1470-2045(09)70254-2 6408:10.1158/0008-5472.CAN-09-3416 5767:10.1016/S0960-9776(09)70290-5 4981:10.1158/1078-0432.CCR-10-2021 4863:10.1158/1078-0432.CCR-06-3045 3862:10.1158/0008-5472.CAN-04-1945 3565:10.1158/1055-9965.EPI-08-1082 3451:10.1093/jncimonographs/lgq027 3191: 3147:AO with 10x eyepiece: 0.12 mm 2820: 2754:, which is termed a positive 2679:look at different individual 2664: 2577:. The use of these assays in 2501: 2090:triple negative breast cancer 1882:AJCC; original pages 101-108 1868:AJCC; original pages 127-134 1854:AJCC; original pages 145-150 1840:AJCC; original pages 149-154 1826:AJCC; original pages 171-180 1812:AJCC; original pages 223-240 186:Paget's disease of the nipple 152:lymphovascular space invasion 6921:Journal of Clinical Oncology 6882:Journal of Clinical Oncology 6446:Journal of Clinical Oncology 6348:Journal of Clinical Oncology 6063:Journal of Clinical Oncology 5981:Journal of Clinical Oncology 5842:Journal of Clinical Oncology 5556:Journal of Clinical Oncology 5321:10.1097/PAP.0000000000000232 5177:10.1097/PAP.0b013e3181a9d4bf 5035:10.1016/j.molonc.2010.11.003 4647:Journal of Clinical Oncology 3332:Food and Drug Administration 2832:Food and Drug Administration 2665:breast cancer classification 2099:Luminal A: ER+ and low grade 1043:Benign tumors of the nipple 527:Invasive papillary carcinoma 249:Food and Drug Administration 211:Receptor status. Cells have 173: 7: 7455:Atypical ductal hyperplasia 4623:10.1056/NEJM198506203122504 3221:10.1007/978-0-387-74039-3_1 3211:. In Yu D, Hung MC (eds.). 3141:for some microscope types: 2599:randomized controlled trial 2473: 2379:FOXM1-related transcription 2322:HER2 positive or high Ki-67 2213:proliferation-related genes 2178:Proliferation-related genes 2125:cell-cell junction proteins 1552:supraclavicular lymph nodes 1518:T4a: Chest wall involvement 986:Adenomyoepithelial adenosis 850:Atypical ductal hyperplasia 846:Flat epithelial hyperplasia 387:Invasive breast carcinomas 95: 53:the best evidence available 10: 7581: 7447:Inflammatory breast cancer 7432:Medullary breast carcinoma 7304:Breast cancer chemotherapy 6838:Expert Opin. Ther. Targets 5654:10.1038/nrclinonc.2010.142 4225:Last Update: 4 June 2019. 3491:10.1016/j.ejca.2017.05.030 3479:European Journal of Cancer 2995:Tumors overexpressing the 2908: 2894: 2860: 2841: 2668: 2481:status can be analyzed by 2438:more quickly have a worse 2366:Similar to luminal A but: 2316:Estrogen receptor positive 2300:Estrogen receptor positive 2065: 1908:use in the investigation. 1529:Inflammatory breast cancer 895:Benign epithelial lesions 777:Tumors of the male breast 666:Bilateral breast carcinoma 653:-rich clear cell carcinoma 607:Matrix-producing carcinoma 482:Signet ring cell carcinoma 432:Invasive lobular carcinoma 359:Invasive lobular carcinoma 158: 114: 110: 77:inflammatory breast cancer 29: 25: 7474: 7424: 7397: 7369: 7329: 7322: 7314:Breast-conserving surgery 7294: 7234: 7155:J Natl Cancer Inst Monogr 7106:British Journal of Cancer 6894:10.1200/JCO.2001.19.4.980 6850:10.1517/14728220902911509 6290:British Journal of Cancer 5891:29 September 2011 at the 5744:Albain, K. S.; Paik, S.; 5276:10.1007/s10549-011-1619-7 5080:10.1080/00313020802563536 4596:28 September 2011 at the 4577:28 September 2011 at the 4558:28 September 2011 at the 4539:28 September 2011 at the 4520:28 September 2011 at the 4501:28 September 2011 at the 3909:British Journal of Cancer 3399:Robbins, Stanley (2010). 3312:, Ch. 253, Breast Cancer. 3104:Van Nuys prognostic index 3069:Adjuvant! is based on US 2788:with the likelihood of a 2659:: Theros and MapQuant Dx. 2376:Myc-related transcription 2252:Invasive ductal carcinoma 1928:National Cancer Institute 1782:link(s) and page numbers 1508:T3: Larger than 5 cm 1477:lobular carcinoma in situ 1293: 1290: 831:lobular carcinoma in situ 377:World Health Organization 355:invasive ductal carcinoma 6459:10.1200/JCO.2008.18.8391 6360:10.1200/JCO.2009.25.4011 6271:3 September 2011 at the 6214:23 November 2013 at the 6195:22 December 2010 at the 6076:10.1200/JCO.2008.20.2119 5994:10.1200/JCO.2005.02.0818 5854:10.1200/JCO.2007.14.2364 5609:10.1177/1740774510368574 5569:10.1200/JCO.2009.25.2882 4969:Clinical Cancer Research 4850:Clinical Cancer Research 4387:10.3389/fonc.2022.982461 4232:21 November 2015 at the 4059:10.4103/0973-1482.140979 3115: 3110:ductal carcinoma in situ 2838:MammaPrint and BluePrint 2695:predictions of outcome. 2691:groups and thus provide 2677:gene-expression profiles 2286:Adenoid cyctic carcinoma 2255:Micropapillary carcinoma 2189:Luminal epithelial genes 2167:Luminal epithelial genes 2161:Overall gene expression 1538:Regional Lymph Nodes (N) 1473:ductal carcinoma in situ 1404: 1086: 998:Fibroepithelial tumours 994:Malignant myoepithelioma 855:Ductal carcinoma in situ 641:Adenoid cystic carcinoma 578:Mucoepidermoid carcinoma 520:neuroendocrine carcinoma 278:ductal carcinoma in situ 204:Metastatic breast cancer 190:ductal carcinoma in situ 138:mammary ductal carcinoma 7482:Breast cancer awareness 6934:10.1200/JCO.2005.06.178 6559:10.1073/pnas.0911220107 6500:10.1186/1476-4598-9-300 5226:10.1073/pnas.1018862108 4659:10.1200/JCO.2003.03.052 4334:"Breast Cancer Staging" 4173:Originally copied from 3433:Kerlikowske, K (2010). 3153:Leitz Ortholux: 0.27 mm 2891:gene expression profile 2883:MammaPrint main article 1485:T1: Less than 2 cm 866:Microinvasive carcinoma 573:Adenosquamous carcinoma 559:Squamous cell carcinoma 7565:Classification systems 7560:Medical classification 7118:10.1038/sj.bjc.6605736 7055:Breast Cancer Research 7018:10.1038/sj.bjc.6605283 6672:Breast Cancer Research 6598:11 August 2011 at the 6303:10.1038/sj.bjc.6601185 5505:Breast Cancer Research 4856:(15 Pt 1): 4429–4434. 4130:27 August 2013 at the 3830:Updated: 20 March 2019 3666:Breast Cancer Research 3156:Leitz Diaplan: 0.31 mm 2641:, can be performed on 2556:DNA expression profile 2511: 2025:triple negative cancer 1970:progesterone receptors 1638:Distant Metastases (M) 1542:Lymph Node – The 1263: 1187:cellular abnormalities 1128: 979:Myoepithelial lesions 939:Radial scar / complex 662:Inflammatory carcinoma 610:Spindle cell carcinoma 321: 310: 245:Trastuzumab deruxtecan 107:histopathological type 7361:Intraductal papilloma 6801:Endocr. Relat. Cancer 6147:28 March 2012 at the 6118:10.1093/annonc/mdr278 5114:Perou, C. M. (2011). 4762:10.1056/NEJMra0801289 3393:6 August 2022 at the 2997:Wnt signaling pathway 2738:. The test is run on 2637:is supported only by 2509: 2278:Metaplastic carcinoma 2185:Lower expression of: 1737:Staging and prognosis 1521:T4b: Skin involvement 1424:progesterone receptor 1282:Mitotic count per 10 1261: 1189:should be evaluated. 1162:assesses whether the 1126: 902:, including variants 646:Acinic cell carcinoma 316: 308: 233:progesterone receptor 6173:25 July 2011 at the 5811:10.1056/NEJMoa052933 5158:Ross, J. S. (2009). 4814:10.1056/NEJMoa052122 4482:26 June 2011 at the 4354:Updated: 8 June 2019 3540:23 February 2013 at 3529:23 February 2013 at 2959:polymorphic variants 2703:, particularly with 2487:immunohistochemistry 2294:Immunohistochemistry 2207:High expression of: 2164:High expression of: 2153:ERBB2/HER2-amplified 2009:aromatase inhibitors 1959:immunohistochemistry 1580:immunohistochemistry 1550:), the collar area ( 1548:axillary lymph nodes 1154:Nuclear pleomorphism 1102:nuclear pleomorphism 880:Peripheral papilloma 815:Non-Hodgkin lymphoma 727:Granular cell tumour 6814:10.1677/erc.1.01222 6763:10.1038/nature07483 6754:2008Natur.456..663H 6724:on 20 February 2009 6618:7 July 2011 at the 6550:2010PNAS..107.5136L 6252:5 June 2011 at the 6233:5 June 2011 at the 5376:2000Natur.406..747P 4156:8 June 2011 at the 3955:Anticancer Research 3921:10.1038/bjc.1957.43 3699:8 July 2011 at the 3308:1 July 2010 at the 3090:immunohistochemical 2978:inhibitors such as 2360:CCDN1 amplification 2282:Medullary carcinoma 2217:Low expression of: 2141: 1989:targeted treatments 1681: 1524:T4c: Both 4a and 4b 1287: 1029:Periductal stromal 990:Adenomyoepithelioma 969:Pleomorphic adenoma 931:Adenomyoepithelial 810:Malignant lymphoma 657:Sebaceous carcinoma 636:Oncocytic carcinoma 631:Secretory carcinoma 57:confounding effects 7451:Precursor lesions 7442:Male breast cancer 6645:10.2217/pgs.10.112 6105:Annals of Oncology 6035:10.1002/cncr.25269 5642:Nat Rev Clin Oncol 5023:Molecular Oncology 4888:. Cancer Network. 3660:Evans, A. (2004). 2657:Level III evidence 2639:Level III evidence 2587:Level III evidence 2545:(TNBC) basal-like 2512: 2418:DNA classification 2221:HER2-related genes 2181:HER2-related genes 2139: 2117:Normal breast-like 1679: 1505:T2: 2 to 5 cm 1498:T1c: 1.0 to 2.0 cm 1495:T1b: 0.5 to 1.0 cm 1492:T1a: 0.1 to 0.5 cm 1281: 1270:assesses how many 1264: 1129: 883:Atypical papilloma 827:Lobular neoplasia 823:Precursor lesions 792:Male breast cancer 689:Hemangiopericytoma 566:with spindle cell 514:oat cell carcinoma 477:mucinous carcinoma 469:Cystadenocarcinoma 392:Invasive carcinoma 371:WHO classification 322: 311: 167:TNM classification 148:invasive carcinoma 91:Schemes or aspects 75:findings, is that 28:of the tumor, the 7510: 7509: 7470: 7469: 6973:(11): 1070–1076. 6927:(12): 2716–2725. 6748:(7222): 663–666. 6639:(10): 1367–1375. 6544:(11): 5136–5141. 6452:(16): 2630–2637. 6402:(15): 6268–6276. 6354:(20): 3366–3379. 6069:(10): 1671–1676. 6028:(22): 5161–5167. 5987:(29): 7265–7277. 5848:(33): 5287–5312. 5470:10.1159/000258489 5427:10.2325/jbcs.13.2 5370:(6797): 747–752. 4807:(16): 1673–1684. 4653:(17): 3244–3248. 4617:(25): 1604–1608. 4450:on 6 January 2011 4015:Stanford Medicine 3985:Stanford Medicine 3855:(23): 8534–8540. 3779:: 154–161. 2002. 3722:978-92-832-2412-9 3615:Breast Cancer Res 3410:978-1-4377-2182-9 3258:Breast Cancer Res 3230:978-0-387-74037-9 3044:interaction with 2790:complete response 2675:. Although these 2614:Level II evidence 2583:Level II evidence 2489:with response to 2415: 2414: 2406:MYC amplification 2388:signaling pathway 2370:TP53 inactivation 2239:Tubular carcinoma 2082:following section 2042:Molecular subtype 2035:Androgen receptor 1982:following section 1902:"stage migration" 1886: 1885: 1757:Previous editions 1747:estrogen receptor 1734: 1733: 1576:routine histology 1460:Tumor – The 1456:Primary Tumor (T) 1448:(UICC) recommend 1420:estrogen receptor 1375: 1374: 1284:high-power fields 1081: 1080: 442:Tubular carcinoma 229:estrogen receptor 200:metastatic cancer 143:Carcinoma in situ 22:histopathological 7572: 7545:Breast neoplasia 7527: 7526: 7525: 7518: 7399:Fibroepithelials 7327: 7326: 7279:Self-examination 7221: 7214: 7207: 7198: 7197: 7191: 7190: 7180: 7170: 7146: 7140: 7139: 7129: 7097: 7091: 7090: 7080: 7070: 7046: 7040: 7039: 7029: 6997: 6991: 6990: 6961: 6955: 6954: 6936: 6912: 6906: 6905: 6876: 6870: 6869: 6833: 6827: 6826: 6816: 6792: 6786: 6785: 6775: 6765: 6733: 6731: 6729: 6714: 6708: 6707: 6697: 6687: 6663: 6657: 6656: 6633:Pharmacogenomics 6628: 6622: 6608: 6602: 6588: 6582: 6581: 6571: 6561: 6529: 6523: 6522: 6512: 6502: 6487:Molecular Cancer 6478: 6472: 6471: 6461: 6437: 6431: 6429: 6419: 6387: 6381: 6378: 6372: 6371: 6343: 6337: 6332: 6326: 6325: 6315: 6305: 6281: 6275: 6262: 6256: 6243: 6237: 6224: 6218: 6205: 6199: 6186: 6177: 6164: 6151: 6137: 6131: 6130: 6120: 6095: 6089: 6088: 6078: 6054: 6048: 6047: 6037: 6013: 6007: 6006: 5996: 5972: 5966: 5965: 5963: 5961: 5956:on 26 March 2012 5955: 5949:. 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Archived from 4439: 4424: 4423: 4417: 4409: 4399: 4389: 4364: 4355: 4353: 4351: 4349: 4329: 4316: 4311: 4301: 4277: 4271: 4270: 4242: 4236: 4224: 4218: 4214: 4212: 4204: 4202: 4200: 4171: 4160: 4147: 4134: 4121: 4112: 4111: 4109: 4107: 4086: 4080: 4079: 4061: 4037: 4031: 4030: 4028: 4026: 4007: 4001: 4000: 3998: 3996: 3977: 3971: 3970: 3949: 3943: 3942: 3932: 3900: 3894: 3893: 3881: 3875: 3874: 3864: 3837: 3831: 3829: 3827: 3825: 3803: 3797: 3796: 3769: 3733: 3727: 3726: 3709: 3703: 3693: 3691: 3681: 3657: 3651: 3650: 3640: 3630: 3603: 3597: 3596: 3594: 3592: 3587:on 15 April 2009 3583:. Archived from 3577: 3567: 3520: 3511: 3510: 3472: 3462: 3429: 3423: 3422: 3385: 3372: 3366: 3360: 3354: 3353: 3349: 3347: 3345: 3322: 3313: 3300: 3294: 3293: 3283: 3273: 3249: 3243: 3242: 3210: 3202: 3185: 3182: 3180: 3178: 3139:high-power field 3135: 3008:variant genotype 2932:Topoisomerase II 2782:hormonal therapy 2667:methods such as 2612:is supported by 2591:Level I evidence 2581:is supported by 2530:receptor-related 2232:Light microscopy 2224:ER-related genes 2192:ER-related genes 2170:ER-related genes 2142: 2138: 2068:, to categorize 1784:in the original 1777:went into effect 1768: 1767: 1743:AJCC 8th edition 1682: 1678: 1556:pectoralis minor 1288: 1280: 1245: 1233: 1221: 1209: 1119:Tubule formation 1098:tubule formation 1008:Phyllodes tumour 752:Rhabdomyosarcoma 699:Myofibroblastoma 383: 350:rates of 97-99%. 344:breast screening 326:light microscopy 7580: 7579: 7575: 7574: 7573: 7571: 7570: 7569: 7535: 7534: 7533: 7523: 7521: 7513: 7511: 7506: 7466: 7420: 7416:Phyllodes tumor 7393: 7365: 7351:Comedocarcinoma 7318: 7290: 7230: 7225: 7195: 7194: 7161:(41): 193–196. 7147: 7143: 7098: 7094: 7068:10.1186/bcr2464 7047: 7043: 6998: 6994: 6967:Lancet Oncology 6962: 6958: 6913: 6909: 6877: 6873: 6834: 6830: 6793: 6789: 6734: 6727: 6725: 6716: 6715: 6711: 6685:10.1186/bcr2612 6664: 6660: 6629: 6625: 6620:Wayback Machine 6609: 6605: 6600:Wayback Machine 6589: 6585: 6530: 6526: 6479: 6475: 6438: 6434: 6396:Cancer Research 6388: 6384: 6379: 6375: 6344: 6340: 6333: 6329: 6282: 6278: 6273:Wayback Machine 6263: 6259: 6254:Wayback Machine 6244: 6240: 6235:Wayback Machine 6225: 6221: 6216:Wayback Machine 6206: 6202: 6197:Wayback Machine 6187: 6180: 6175:Wayback Machine 6165: 6154: 6149:Wayback Machine 6138: 6134: 6096: 6092: 6055: 6051: 6014: 6010: 5973: 5969: 5959: 5957: 5953: 5942: 5938: 5937: 5933: 5902: 5898: 5893:Wayback Machine 5883: 5879: 5834: 5827: 5790: 5783: 5742: 5733: 5688: 5677: 5638: 5634: 5589: 5585: 5548: 5544: 5518:10.1186/bcr2596 5497: 5493: 5454: 5450: 5411: 5407: 5356: 5352: 5305: 5301: 5256: 5252: 5205: 5201: 5156: 5149: 5112: 5103: 5064: 5060: 5015: 5006: 4961: 4957: 4912: 4905: 4895: 4893: 4884: 4883: 4879: 4842: 4838: 4793: 4789: 4779: 4777: 4742: 4733: 4723: 4721: 4717: 4710: 4706: 4705: 4674: 4642: 4638: 4607: 4603: 4598:Wayback Machine 4588: 4584: 4579:Wayback Machine 4569: 4565: 4560:Wayback Machine 4550: 4546: 4541:Wayback Machine 4531: 4527: 4522:Wayback Machine 4512: 4508: 4503:Wayback Machine 4493: 4489: 4484:Wayback Machine 4474: 4463: 4453: 4451: 4442: 4440: 4427: 4411: 4410: 4365: 4358: 4347: 4345: 4330: 4319: 4278: 4274: 4243: 4239: 4234:Wayback Machine 4216: 4215: 4206: 4205: 4198: 4196: 4177:"Breast Cancer" 4172: 4163: 4158:Wayback Machine 4148: 4137: 4132:Wayback Machine 4122: 4115: 4105: 4103: 4088: 4087: 4083: 4038: 4034: 4024: 4022: 4009: 4008: 4004: 3994: 3992: 3979: 3978: 3974: 3950: 3946: 3901: 3897: 3882: 3878: 3849:Cancer Research 3838: 3834: 3823: 3821: 3804: 3800: 3771:"Republished". 3770: 3734: 3730: 3723: 3711: 3710: 3706: 3701:Wayback Machine 3672:(Suppl 1): 23. 3658: 3654: 3604: 3600: 3590: 3588: 3579: 3544:(in situ) from 3533:(invasive) and 3521: 3514: 3473: 3430: 3426: 3411: 3395:Wayback Machine 3386: 3375: 3367: 3363: 3351: 3343: 3341: 3324: 3323: 3316: 3310:Wayback Machine 3301: 3297: 3250: 3246: 3231: 3203: 3199: 3194: 3189: 3188: 3176: 3174: 3159: 3157: 3136: 3123: 3118: 3106: 3086: 3059: 3057:Computer models 3054: 2986:DNA methylation 2964:PARP inhibitors 2928: 2879:clinical trials 2846: 2840: 2807:(ASCO) and the 2721: 2673:receptor status 2627:(ASCO) and the 2515:DNA microarrays 2504: 2499: 2497:DNA microarrays 2476: 2425: 2420: 2373:Rb inactivation 2346:Gene mutations 2078:DNA microarrays 2044: 1947: 1945:Receptor status 1783: 1781: 1759: 1739: 1689: 1657: 1640: 1598:micrometastasis 1540: 1481:Paget's disease 1458: 1444:(AJCC) and the 1407: 1380: 1256: 1249: 1246: 1237: 1234: 1225: 1222: 1213: 1210: 1156: 1121: 1089: 1082: 1070:Paget's disease 1059:Paget's disease 983:Myoepitheliosis 952:Tubular adenoma 925:Microglandular 772: 627:-rich carcinoma 419:choriocarcinoma 417:Carcinoma with 410:Carcinoma with 373: 363:5-year survival 348:5-year survival 340:breast biopsies 303: 241:triple negative 122:receptor status 98: 93: 12: 11: 5: 7578: 7568: 7567: 7562: 7557: 7555:Cancer staging 7552: 7547: 7532: 7531: 7508: 7507: 7505: 7504: 7499: 7494: 7489: 7484: 7478: 7476: 7472: 7471: 7468: 7467: 7465: 7464: 7462:Nipple adenoma 7459: 7458: 7457: 7449: 7444: 7439: 7434: 7428: 7426: 7422: 7421: 7419: 7418: 7413: 7407: 7405: 7395: 7394: 7392: 7391: 7386: 7381: 7375: 7373: 7367: 7366: 7364: 7363: 7358: 7353: 7348: 7347: 7346: 7335: 7333: 7324: 7320: 7319: 7317: 7316: 7311: 7306: 7300: 7298: 7292: 7291: 7289: 7288: 7283: 7282: 7281: 7271: 7270: 7269: 7264: 7259: 7249: 7247:Classification 7244: 7238: 7236: 7232: 7231: 7224: 7223: 7216: 7209: 7201: 7193: 7192: 7141: 7092: 7041: 7012:(7): 1074–84. 6992: 6956: 6907: 6888:(4): 980–991. 6871: 6828: 6807:(4): 1135–45. 6787: 6709: 6658: 6623: 6603: 6583: 6524: 6473: 6432: 6382: 6373: 6338: 6327: 6296:(4): 666–671. 6276: 6257: 6238: 6219: 6200: 6178: 6152: 6132: 6111:(3): 625–631. 6090: 6049: 6008: 5967: 5931: 5896: 5877: 5825: 5804:(6): 560–569. 5781: 5746:Van't Veer, L. 5731: 5702:(5): 477–493. 5696:The Oncologist 5675: 5632: 5583: 5562:(10): 1625–7. 5542: 5491: 5448: 5405: 5350: 5299: 5270:(2): 523–535. 5250: 5199: 5170:(4): 204–215. 5147: 5120:The Oncologist 5101: 5058: 5004: 4955: 4903: 4877: 4836: 4787: 4756:(8): 790–800. 4731: 4672: 4636: 4601: 4582: 4563: 4544: 4525: 4506: 4487: 4461: 4425: 4356: 4317: 4272: 4237: 4217:|website= 4183:. StatPearls. 4181:Cancer, Breast 4161: 4135: 4113: 4081: 4052:(4): 839–845. 4032: 4002: 3972: 3944: 3895: 3892:(19): 403–410. 3886:Histopathology 3876: 3832: 3806:Oudai Hassan. 3798: 3773:Histopathology 3738:Histopathology 3728: 3721: 3704: 3679:10.1186/bcr842 3652: 3628:10.1186/bcr767 3621:(3): R149–56. 3598: 3512: 3445:(41): 139–41. 3424: 3409: 3373: 3361: 3314: 3295: 3271:10.1186/bcr608 3244: 3229: 3196: 3195: 3193: 3190: 3187: 3186: 3184: 3183: 3154: 3151: 3148: 3145: 3120: 3119: 3117: 3114: 3105: 3102: 3085: 3082: 3058: 3055: 3053: 3050: 2990:epigenetically 2927: 2924: 2922:gene profile. 2858:breast cancers 2842:Main article: 2839: 2836: 2823:elements when 2821:classification 2786:classification 2734:(ER) positive 2720: 2717: 2661: 2660: 2653: 2632: 2579:breast cancers 2565:tests analyze 2563:DNA microarray 2525:have included 2503: 2500: 2498: 2495: 2475: 2472: 2432:classification 2424: 2421: 2419: 2416: 2413: 2412: 2411: 2410: 2407: 2404: 2401: 2398: 2393: 2392: 2391: 2382: 2381: 2380: 2377: 2374: 2371: 2363: 2362: 2361: 2358: 2355: 2352: 2347: 2343: 2342: 2341: 2340: 2335: 2334: 2333: 2330: 2325: 2324: 2323: 2320: 2317: 2312: 2311: 2310: 2307: 2304: 2301: 2296: 2290: 2289: 2288: 2287: 2284: 2279: 2276: 2271: 2270: 2269: 2266: 2261: 2260: 2259: 2256: 2253: 2248: 2247: 2246: 2243: 2240: 2235: 2228: 2227: 2226: 2225: 2222: 2215: 2214: 2211: 2205: 2204: 2203: 2200: 2195: 2194: 2193: 2190: 2183: 2182: 2179: 2173: 2172: 2171: 2168: 2162: 2158: 2157: 2154: 2151: 2148: 2145: 2137: 2136: 2118: 2115: 2109: 2103: 2100: 2097: 2043: 2040: 1955:breast cancers 1946: 1943: 1884: 1883: 1880: 1877: 1874: 1870: 1869: 1866: 1863: 1860: 1856: 1855: 1852: 1849: 1846: 1842: 1841: 1838: 1835: 1832: 1828: 1827: 1824: 1821: 1818: 1814: 1813: 1810: 1807: 1804: 1800: 1799: 1796: 1793: 1790: 1786: 1785: 1780:Breast cancer 1778: 1775: 1772: 1758: 1755: 1738: 1735: 1732: 1731: 1728: 1724: 1723: 1720: 1716: 1715: 1712: 1708: 1707: 1704: 1700: 1699: 1696: 1692: 1691: 1686: 1677: 1676: 1673: 1670: 1667: 1664: 1656: 1653: 1652: 1651: 1648: 1644: 1639: 1636: 1635: 1634: 1633: 1632: 1629: 1626: 1620: 1619: 1616: 1612: 1611: 1610: 1609: 1602: 1601: 1593: 1592: 1591: 1590: 1583: 1568: 1567: 1539: 1536: 1535: 1534: 1533: 1532: 1525: 1522: 1519: 1513: 1512: 1509: 1506: 1502: 1501: 1500: 1499: 1496: 1493: 1487: 1486: 1483: 1469: 1457: 1454: 1406: 1403: 1398: 1397: 1394: 1391: 1379: 1376: 1373: 1372: 1369: 1366: 1363: 1360: 1357: 1353: 1352: 1349: 1346: 1343: 1340: 1337: 1333: 1332: 1329: 1326: 1323: 1320: 1317: 1313: 1312: 1309: 1306: 1303: 1300: 1296: 1295: 1292: 1255: 1252: 1251: 1250: 1247: 1240: 1238: 1235: 1228: 1226: 1223: 1216: 1214: 1211: 1204: 1201: 1200: 1197: 1194: 1155: 1152: 1151: 1150: 1147: 1144: 1120: 1117: 1088: 1085: 1079: 1078: 1074: 1073: 1063: 1062: 1056: 1050: 1048:Nipple adenoma 1041: 1040: 1034: 1027: 1026: 1025: 1020: 1015: 1005: 996: 995: 992: 987: 984: 977: 976: 975: 974: 973:Ductal adenoma 971: 966: 960: 954: 944: 937: 936: 935: 929: 923: 917: 909: 893: 892: 891: 890: 887: 884: 881: 878: 867: 864: 863: 862: 857: 852: 847: 844: 835: 834: 833: 818: 817: 808: 807: 806: 805: 800: 785: 774: 770: 769: 767:Leiomyosarcoma 764: 759: 754: 749: 744: 739: 734: 729: 724: 723: 722: 712: 707: 701: 696: 691: 686: 681: 668: 667: 664: 659: 654: 648: 643: 638: 633: 628: 622: 621: 620: 617: 614: 613:Carcinosarcoma 611: 608: 599: 598: 597: 596: 582: 581: 580: 575: 570: 564:Adenocarcinoma 561: 540: 537: 532: 529: 524: 523: 522: 516: 510: 503: 502:of the breast) 496:neuroendocrine 489:Neuroendocrine 486: 485: 484: 479: 466: 455: 450: 444: 435: 434: 429: 428: 427: 426: 425: 422: 415: 408: 402: 397: 381: 372: 369: 368: 367: 351: 302: 301:Histopathology 299: 298: 297: 296: 295: 288: 281: 274: 264: 252: 209: 208: 207: 196: 193: 163: 155: 97: 94: 92: 89: 9: 6: 4: 3: 2: 7577: 7566: 7563: 7561: 7558: 7556: 7553: 7551: 7550:Breast cancer 7548: 7546: 7543: 7542: 7540: 7530: 7520: 7519: 7516: 7503: 7500: 7498: 7495: 7493: 7490: 7488: 7485: 7483: 7480: 7479: 7477: 7473: 7463: 7460: 7456: 7453: 7452: 7450: 7448: 7445: 7443: 7440: 7438: 7435: 7433: 7430: 7429: 7427: 7423: 7417: 7414: 7412: 7409: 7408: 7406: 7404: 7400: 7396: 7390: 7387: 7385: 7382: 7380: 7377: 7376: 7374: 7372: 7368: 7362: 7359: 7357: 7354: 7352: 7349: 7345: 7342: 7341: 7340: 7337: 7336: 7334: 7332: 7328: 7325: 7321: 7315: 7312: 7310: 7307: 7305: 7302: 7301: 7299: 7297: 7293: 7287: 7284: 7280: 7277: 7276: 7275: 7272: 7268: 7267:BRCA mutation 7265: 7263: 7260: 7258: 7255: 7254: 7253: 7250: 7248: 7245: 7243: 7242:Breast cancer 7240: 7239: 7237: 7233: 7229: 7228:Breast cancer 7222: 7217: 7215: 7210: 7208: 7203: 7202: 7199: 7188: 7184: 7179: 7174: 7169: 7164: 7160: 7156: 7152: 7145: 7137: 7133: 7128: 7123: 7119: 7115: 7112:(5): 668–75. 7111: 7107: 7103: 7096: 7088: 7084: 7079: 7074: 7069: 7064: 7060: 7056: 7052: 7045: 7037: 7033: 7028: 7023: 7019: 7015: 7011: 7007: 7006:Br. J. Cancer 7003: 6996: 6988: 6984: 6980: 6976: 6972: 6968: 6960: 6952: 6948: 6944: 6940: 6935: 6930: 6926: 6922: 6918: 6911: 6903: 6899: 6895: 6891: 6887: 6883: 6875: 6867: 6863: 6859: 6855: 6851: 6847: 6844:(6): 665–74. 6843: 6839: 6832: 6824: 6820: 6815: 6810: 6806: 6802: 6798: 6791: 6783: 6779: 6774: 6769: 6764: 6759: 6755: 6751: 6747: 6743: 6739: 6723: 6719: 6713: 6705: 6701: 6696: 6691: 6686: 6681: 6677: 6673: 6669: 6662: 6654: 6650: 6646: 6642: 6638: 6634: 6627: 6621: 6617: 6614: 6607: 6601: 6597: 6594: 6587: 6579: 6575: 6570: 6565: 6560: 6555: 6551: 6547: 6543: 6539: 6535: 6528: 6520: 6516: 6511: 6506: 6501: 6496: 6492: 6488: 6484: 6477: 6469: 6465: 6460: 6455: 6451: 6447: 6443: 6436: 6427: 6423: 6418: 6413: 6409: 6405: 6401: 6397: 6393: 6386: 6377: 6369: 6365: 6361: 6357: 6353: 6349: 6342: 6336: 6331: 6323: 6319: 6314: 6309: 6304: 6299: 6295: 6291: 6287: 6280: 6274: 6270: 6267: 6261: 6255: 6251: 6248: 6242: 6236: 6232: 6229: 6223: 6217: 6213: 6210: 6204: 6198: 6194: 6191: 6185: 6183: 6176: 6172: 6169: 6163: 6161: 6159: 6157: 6150: 6146: 6143: 6136: 6128: 6124: 6119: 6114: 6110: 6106: 6102: 6094: 6086: 6082: 6077: 6072: 6068: 6064: 6060: 6053: 6045: 6041: 6036: 6031: 6027: 6023: 6019: 6012: 6004: 6000: 5995: 5990: 5986: 5982: 5978: 5971: 5952: 5948: 5941: 5935: 5927: 5923: 5919: 5915: 5911: 5907: 5900: 5894: 5890: 5887: 5881: 5873: 5869: 5864: 5859: 5855: 5851: 5847: 5843: 5839: 5832: 5830: 5821: 5817: 5812: 5807: 5803: 5799: 5795: 5788: 5786: 5777: 5773: 5768: 5763: 5760:: S141–S145. 5759: 5755: 5751: 5747: 5740: 5738: 5736: 5727: 5723: 5719: 5715: 5710: 5705: 5701: 5697: 5693: 5686: 5684: 5682: 5680: 5671: 5667: 5663: 5659: 5655: 5651: 5648:(11): 615–6. 5647: 5643: 5636: 5628: 5624: 5619: 5614: 5610: 5606: 5603:(5): 567–73. 5602: 5598: 5594: 5587: 5579: 5575: 5570: 5565: 5561: 5557: 5553: 5546: 5538: 5534: 5529: 5524: 5519: 5514: 5510: 5506: 5502: 5495: 5487: 5483: 5479: 5475: 5471: 5467: 5463: 5459: 5452: 5444: 5440: 5436: 5432: 5428: 5424: 5420: 5416: 5415:Breast Cancer 5409: 5401: 5397: 5393: 5389: 5385: 5381: 5377: 5373: 5369: 5365: 5361: 5354: 5346: 5342: 5338: 5334: 5330: 5326: 5322: 5318: 5314: 5310: 5303: 5295: 5291: 5286: 5281: 5277: 5273: 5269: 5265: 5261: 5254: 5246: 5242: 5237: 5232: 5227: 5222: 5218: 5214: 5210: 5203: 5195: 5191: 5187: 5183: 5178: 5173: 5169: 5165: 5161: 5154: 5152: 5143: 5139: 5134: 5129: 5125: 5121: 5117: 5110: 5108: 5106: 5097: 5093: 5089: 5085: 5081: 5077: 5073: 5069: 5062: 5054: 5050: 5045: 5040: 5036: 5032: 5028: 5024: 5020: 5013: 5011: 5009: 5000: 4996: 4991: 4986: 4982: 4978: 4974: 4970: 4966: 4959: 4951: 4947: 4942: 4937: 4933: 4929: 4925: 4921: 4917: 4910: 4908: 4891: 4887: 4881: 4873: 4869: 4864: 4859: 4855: 4851: 4847: 4840: 4832: 4828: 4824: 4820: 4815: 4810: 4806: 4802: 4798: 4791: 4775: 4771: 4767: 4763: 4759: 4755: 4751: 4747: 4740: 4738: 4736: 4716: 4709: 4703: 4701: 4699: 4697: 4695: 4693: 4691: 4689: 4687: 4685: 4683: 4681: 4679: 4677: 4668: 4664: 4660: 4656: 4652: 4648: 4640: 4632: 4628: 4624: 4620: 4616: 4612: 4605: 4599: 4595: 4592: 4586: 4580: 4576: 4573: 4567: 4561: 4557: 4554: 4548: 4542: 4538: 4535: 4529: 4523: 4519: 4516: 4510: 4504: 4500: 4497: 4491: 4485: 4481: 4478: 4472: 4470: 4468: 4466: 4449: 4445: 4438: 4436: 4434: 4432: 4430: 4421: 4415: 4407: 4403: 4398: 4393: 4388: 4383: 4379: 4375: 4371: 4363: 4361: 4343: 4339: 4335: 4328: 4326: 4324: 4322: 4315: 4309: 4305: 4300: 4295: 4292:(5): 857–70. 4291: 4287: 4286:Radiographics 4283: 4276: 4268: 4264: 4260: 4256: 4252: 4248: 4241: 4235: 4231: 4228: 4222: 4210: 4194: 4190: 4186: 4182: 4178: 4170: 4168: 4166: 4159: 4155: 4152: 4146: 4144: 4142: 4140: 4133: 4129: 4126: 4120: 4118: 4101: 4097: 4096: 4091: 4085: 4077: 4073: 4069: 4065: 4060: 4055: 4051: 4047: 4043: 4036: 4020: 4016: 4012: 4006: 3990: 3986: 3982: 3976: 3968: 3964: 3961:(1B): 571–6. 3960: 3956: 3948: 3940: 3936: 3931: 3926: 3922: 3918: 3915:(3): 359–77. 3914: 3910: 3906: 3899: 3891: 3887: 3880: 3872: 3868: 3863: 3858: 3854: 3850: 3846: 3842: 3836: 3819: 3815: 3814: 3809: 3802: 3794: 3790: 3786: 3782: 3778: 3774: 3767: 3763: 3759: 3755: 3751: 3747: 3744:(5): 403–10. 3743: 3739: 3732: 3724: 3718: 3714: 3708: 3702: 3698: 3695: 3690: 3685: 3680: 3675: 3671: 3667: 3663: 3656: 3648: 3644: 3639: 3634: 3629: 3624: 3620: 3616: 3612: 3607: 3602: 3586: 3582: 3575: 3571: 3566: 3561: 3558:(6): 1763–9. 3557: 3553: 3549: 3543: 3542:archive.today 3539: 3536: 3532: 3531:archive.today 3528: 3525: 3519: 3517: 3508: 3504: 3500: 3496: 3492: 3488: 3484: 3480: 3470: 3466: 3461: 3456: 3452: 3448: 3444: 3440: 3436: 3428: 3420: 3416: 3412: 3406: 3402: 3396: 3392: 3389: 3384: 3382: 3380: 3378: 3371: 3365: 3358: 3357:public domain 3339: 3335: 3333: 3327: 3321: 3319: 3311: 3307: 3304: 3299: 3291: 3287: 3282: 3277: 3272: 3267: 3263: 3259: 3255: 3248: 3240: 3236: 3232: 3226: 3222: 3218: 3214: 3209: 3201: 3197: 3172: 3168: 3167: 3162: 3155: 3152: 3149: 3146: 3143: 3142: 3140: 3134: 3132: 3130: 3128: 3126: 3121: 3113: 3111: 3101: 3099: 3095: 3091: 3081: 3079: 3076: 3072: 3067: 3064: 3049: 3047: 3043: 3039: 3035: 3031: 3027: 3023: 3019: 3015: 3012: 3009: 3004: 3002: 2998: 2993: 2991: 2988:patterns can 2987: 2983: 2981: 2977: 2973: 2972:6-Thioguanine 2969: 2965: 2960: 2957: 2953: 2947: 2945: 2941: 2937: 2933: 2923: 2921: 2917: 2916:breast cancer 2912: 2910: 2909:negative (N0) 2907: 2903: 2900: 2896: 2892: 2888: 2884: 2880: 2877:A summary of 2875: 2873: 2869: 2866: 2862: 2859: 2855: 2851: 2845: 2835: 2833: 2829: 2826: 2822: 2818: 2814: 2810: 2806: 2801: 2798: 2793: 2791: 2787: 2783: 2779: 2775: 2771: 2768: 2764: 2759: 2757: 2753: 2749: 2745: 2741: 2737: 2733: 2730: 2726: 2716: 2714: 2710: 2706: 2702: 2701:controversial 2696: 2694: 2690: 2687:into similar 2686: 2682: 2678: 2674: 2670: 2666: 2658: 2654: 2651: 2647: 2644: 2640: 2636: 2633: 2630: 2626: 2622: 2619: 2615: 2611: 2608: 2607: 2606: 2603: 2600: 2596: 2592: 2588: 2584: 2580: 2576: 2572: 2568: 2564: 2559: 2557: 2553: 2548: 2544: 2539: 2538:proliferation 2535: 2531: 2528: 2524: 2520: 2516: 2508: 2494: 2492: 2488: 2484: 2480: 2471: 2469: 2465: 2461: 2457: 2453: 2449: 2445: 2441: 2437: 2433: 2430: 2408: 2405: 2402: 2399: 2396: 2395: 2394: 2389: 2385: 2384: 2383: 2378: 2375: 2372: 2369: 2368: 2367: 2364: 2359: 2356: 2353: 2350: 2349: 2348: 2345: 2344: 2338: 2337: 2336: 2331: 2329:HER2 positive 2328: 2327: 2326: 2321: 2318: 2315: 2314: 2313: 2308: 2306:HER2 negative 2305: 2302: 2299: 2298: 2297: 2295: 2292: 2291: 2285: 2283: 2280: 2277: 2274: 2273: 2272: 2267: 2264: 2263: 2262: 2257: 2254: 2251: 2250: 2249: 2244: 2241: 2238: 2237: 2236: 2233: 2230: 2229: 2223: 2220: 2219: 2218: 2212: 2209: 2208: 2206: 2201: 2198: 2197: 2196: 2191: 2188: 2187: 2186: 2180: 2177: 2176: 2174: 2169: 2166: 2165: 2163: 2160: 2159: 2155: 2152: 2149: 2146: 2144: 2143: 2134: 2130: 2126: 2122: 2119: 2116: 2114: 2110: 2108: 2104: 2101: 2098: 2095: 2092:(TNBC). Most 2091: 2087: 2086: 2085: 2083: 2079: 2075: 2071: 2070:breast cancer 2067: 2064: 2060: 2056: 2052: 2048: 2039: 2036: 2032: 2030: 2026: 2022: 2018: 2014: 2010: 2006: 2002: 1998: 1994: 1990: 1985: 1983: 1979: 1975: 1971: 1967: 1964: 1960: 1956: 1952: 1942: 1940: 1935: 1933: 1929: 1924: 1921: 1916: 1913: 1909: 1905: 1903: 1897: 1895: 1891: 1881: 1878: 1875: 1872: 1871: 1867: 1864: 1861: 1858: 1857: 1853: 1850: 1847: 1844: 1843: 1839: 1836: 1833: 1830: 1829: 1825: 1822: 1819: 1816: 1815: 1811: 1808: 1805: 1802: 1801: 1797: 1794: 1791: 1788: 1787: 1779: 1776: 1773: 1770: 1769: 1766: 1763: 1754: 1752: 1748: 1744: 1729: 1726: 1725: 1721: 1718: 1717: 1713: 1710: 1709: 1705: 1702: 1701: 1697: 1694: 1693: 1687: 1684: 1683: 1674: 1671: 1668: 1666:Stage I: T1N0 1665: 1662: 1661: 1660: 1655:Overall stage 1649: 1645: 1642: 1641: 1630: 1627: 1624: 1623: 1622: 1621: 1617: 1614: 1613: 1606: 1605: 1604: 1603: 1599: 1595: 1594: 1588: 1584: 1581: 1577: 1572: 1571: 1570: 1569: 1565: 1564: 1563: 1561: 1557: 1553: 1549: 1545: 1530: 1526: 1523: 1520: 1517: 1516: 1515: 1514: 1510: 1507: 1504: 1503: 1497: 1494: 1491: 1490: 1489: 1488: 1484: 1482: 1478: 1474: 1470: 1467: 1466: 1465: 1463: 1453: 1451: 1447: 1443: 1438: 1434: 1431: 1429: 1425: 1421: 1416: 1411: 1402: 1395: 1392: 1389: 1385: 1384: 1383: 1378:Overall grade 1370: 1367: 1364: 1361: 1358: 1355: 1354: 1350: 1347: 1344: 1341: 1338: 1335: 1334: 1330: 1327: 1324: 1321: 1318: 1315: 1314: 1311:0.31 mm 1310: 1307: 1304: 1301: 1299:0.096 mm 1298: 1297: 1289: 1285: 1279: 1276: 1273: 1269: 1260: 1254:Mitotic count 1244: 1239: 1232: 1227: 1220: 1215: 1208: 1203: 1202: 1198: 1195: 1192: 1191: 1190: 1188: 1184: 1179: 1177: 1173: 1169: 1165: 1161: 1148: 1145: 1142: 1141: 1140: 1137: 1134: 1125: 1116: 1113: 1111: 1107: 1106:mitotic count 1103: 1099: 1093: 1084: 1077: 1072:of the nipple 1071: 1068: 1067: 1066: 1061:of the nipple 1060: 1057: 1054: 1053:Syringomatous 1051: 1049: 1046: 1045: 1044: 1039: 1035: 1032: 1028: 1024: 1021: 1019: 1016: 1014: 1011: 1010: 1009: 1006: 1004: 1001: 1000: 999: 993: 991: 988: 985: 982: 981: 980: 972: 970: 967: 964: 961: 958: 955: 953: 950: 949: 948: 945: 942: 938: 934: 930: 928: 924: 922: 918: 916: 913: 910: 907: 904: 903: 901: 898: 897: 896: 888: 885: 882: 879: 877: 873: 872: 871: 868: 865: 861: 858: 856: 853: 851: 848: 845: 843: 840:Usual ductal 839: 838: 836: 832: 829: 828: 826: 825: 824: 821: 816: 813: 812: 811: 804: 801: 799: 796: 795: 793: 789: 786: 783: 780: 779: 778: 775: 773: 768: 765: 763: 760: 758: 755: 753: 750: 748: 745: 743: 740: 738: 735: 733: 730: 728: 725: 721: 718: 717: 716: 713: 711: 708: 705: 702: 700: 697: 695: 692: 690: 687: 685: 682: 680: 677: 676: 675: 673: 665: 663: 660: 658: 655: 652: 649: 647: 644: 642: 639: 637: 634: 632: 629: 626: 623: 618: 615: 612: 609: 606: 605: 604: 603: 602: 594: 591: 587: 583: 579: 576: 574: 571: 569: 565: 562: 560: 557: 556: 554: 551: 547: 546: 544: 541: 538: 536: 533: 530: 528: 525: 521: 517: 515: 512:Small cell / 511: 508: 504: 501: 497: 493: 492: 490: 487: 483: 480: 478: 474: 470: 467: 465: 462: 461: 460: 456: 454: 451: 448: 445: 443: 440: 439: 438: 433: 430: 423: 420: 416: 413: 409: 406: 403: 401: 400: 398: 395: 394: 393: 390: 389: 388: 385: 384: 380: 378: 364: 360: 356: 352: 349: 345: 341: 337: 336: 331: 330: 329: 327: 319: 315: 307: 293: 289: 286: 282: 279: 275: 272: 268: 267: 265: 261: 257: 253: 250: 246: 242: 238: 234: 230: 226: 222: 218: 214: 210: 205: 201: 198:Stage 4 is a 197: 194: 191: 187: 183: 182: 180: 175: 174:breast cancer 172: 168: 164: 160: 156: 153: 149: 145: 144: 139: 135: 131: 130: 129: 127: 123: 119: 116: 112: 108: 104: 103:physical exam 88: 86: 82: 78: 74: 73:physical exam 70: 65: 62: 58: 54: 50: 45: 41: 39: 35: 31: 27: 23: 19: 18:breast cancer 7411:Fibroadenoma 7252:Risk factors 7246: 7158: 7154: 7144: 7109: 7105: 7095: 7058: 7054: 7044: 7009: 7005: 6995: 6970: 6966: 6959: 6924: 6920: 6910: 6885: 6881: 6874: 6841: 6837: 6831: 6804: 6800: 6790: 6745: 6741: 6726:. 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Retrieved 3164: 3107: 3087: 3068: 3060: 3005: 2999:co-receptor 2994: 2984: 2948: 2929: 2913: 2876: 2847: 2817:chemotherapy 2802: 2794: 2778:radiotherapy 2770:chemotherapy 2760: 2752:chemotherapy 2722: 2697: 2662: 2604: 2560: 2513: 2477: 2427:Traditional 2426: 2365: 2216: 2184: 2107:bicalutamide 2045: 2033: 1986: 1948: 1936: 1925: 1917: 1914: 1910: 1906: 1898: 1887: 1798:AJCC or NCI 1771:AJCC edition 1764: 1760: 1740: 1663:Stage 0: Tis 1658: 1541: 1459: 1439: 1435: 1432: 1408: 1399: 1381: 1308:0.27 mm 1305:0.16 mm 1302:0.12 mm 1291:Area per HPF 1277: 1265: 1180: 1157: 1138: 1130: 1114: 1094: 1090: 1083: 1075: 1064: 1042: 1003:Fibroadenoma 997: 978: 894: 822: 819: 809: 782:Gynecomastia 776: 771: 757:Osteosarcoma 742:Angiosarcoma 732:Neurofibroma 706:(aggressive) 704:Fibromatosis 684:Angiomatosis 669: 600: 436: 386: 374: 333: 323: 287:assessments. 147: 141: 99: 69:histological 66: 46: 42: 15: 7487:Pink ribbon 6728:14 November 5960:12 December 5947:ipsogen.com 5597:Clin Trials 5029:(1): 5–23. 4374:Front Oncol 4025:31 December 3995:31 December 3841:Al-Kuraya K 3011:polymorphic 2936:doxorubicin 2825:stratifying 2774:neoadjuvant 2719:Oncotype DX 2610:Oncotype DX 2595:prospective 2491:trastuzumab 2156:Basal-like 2133:lymphocytes 2038:treatment. 2021:trastuzumab 1997:trastuzumab 1450:TNM staging 1176:chromosomes 1168:pleomorphic 1164:cell nuclei 1033:, low-grade 919:Blunt duct 842:hyperplasia 747:Liposarcoma 720:Angiolipoma 593:metaplastic 590:mesenchymal 555:carcinomas 553:metaplastic 545:carcinomas 543:Metaplastic 518:Large cell 498:carcinoma ( 414:giant cells 405:Pleomorphic 285:comorbidity 179:lymph nodes 165:Stage. The 134:histologies 126:DNA testing 7539:Categories 7309:Mastectomy 6678:(4): 206. 5754:The Breast 5511:(3): R42. 5421:(1): 2–7. 4380:: 982461. 4366:Data from 3953:systems". 3192:References 3088:Among the 3063:algorithms 3030:biomarkers 2980:everolimus 2920:MammaPrint 2906:lymph node 2854:lymph node 2844:MammaPrint 2763:prognostic 2756:predictive 2748:prognostic 2709:prognostic 2705:lymph node 2693:concordant 2635:MammaPrint 2502:Background 2460:prognostic 2456:predictive 2403:BRCA1 loss 2129:E-cadherin 2127:including 1953:status of 1920:metastatic 1719:Stage III 1544:lymph node 1479:(LCIS) or 1437:obtained. 1181:Note: The 1018:Borderline 941:sclerosing 906:Sclerosing 737:Schwannoma 679:Hemangioma 595:carcinomas 586:epithelial 568:metaplasia 550:epithelial 412:osteoclast 366:follow-up. 332:Carcinoma 292:mastectomy 271:algorithms 263:effective. 235:(PR), and 81:carcinomas 61:prognostic 49:algorithms 47:Treatment 24:type, the 7296:Treatment 7286:Treatment 7274:Screening 7061:(1): R1. 5345:143423297 5329:1072-4109 5126:: 61–70. 5068:Pathology 4454:3 January 4348:21 August 4247:Radiology 4219:ignored ( 4209:cite book 4199:4 October 4106:2 October 4068:0973-1482 3824:2 October 3793:208083532 3499:0959-8049 3419:489074868 3388:Page 1084 3177:2 October 3137:Area per 3094:prognosis 3026:CYP2C19*2 3018:tamoxifen 2856:negative 2744:prognosis 2652:approval. 2464:TNM stage 2440:prognosis 2390:signature 2309:Low Ki-67 2150:Luminal B 2147:Luminal A 2074:prognoses 2029:prognosis 2013:prognosis 2005:tamoxifen 1993:tamoxifen 1972:(PR) and 1966:receptors 1930:(NCI) or 1774:published 1727:Stage IV 1711:Stage II 1690:survival 1415:prognosis 1388:prognosis 1268:parameter 1160:parameter 1133:parameter 1038:hamartoma 1023:Malignant 957:Lactating 876:papilloma 788:Carcinoma 762:Leiomyoma 507:carcinoid 505:Atypical 500:carcinoid 407:carcinoma 375:The 2012 217:cytoplasm 213:receptors 7529:Medicine 7187:20956828 7136:20664598 7087:20053270 7036:19724274 6987:19801202 6951:27080534 6943:15837986 6902:11181660 6866:39034059 6858:19456271 6823:17158759 6782:19005469 6704:20649975 6653:21047200 6616:Archived 6596:Archived 6578:20194742 6519:21092249 6468:19380449 6426:20631063 6368:20530283 6322:12915875 6269:Archived 6250:Archived 6231:Archived 6212:Archived 6193:Archived 6171:Archived 6145:Archived 6127:21652577 6085:20065191 6044:20665886 6003:16145055 5926:20138540 5889:Archived 5872:17954709 5820:16899776 5776:19914534 5748:(2009). 5726:19435207 5718:18515733 5670:32411967 5662:20981123 5627:20392785 5578:20065178 5537:20576095 5486:21011879 5478:20130425 5458:Oncology 5435:16518056 5392:10963602 5337:31045583 5294:21671017 5245:21633010 5194:37465636 5186:19546609 5142:21278442 5096:39374813 5088:19089743 5053:21147047 4999:21325075 4950:21633166 4890:Archived 4872:17671126 4823:16236738 4774:Archived 4770:19228622 4715:Archived 4667:12947058 4594:Archived 4575:Archived 4556:Archived 4537:Archived 4518:Archived 4499:Archived 4480:Archived 4406:36387150 4342:Archived 4338:medscape 4230:Archived 4193:Archived 4189:29493913 4154:Archived 4128:Archived 4100:Archived 4076:25579516 4019:Archived 3989:Archived 3939:13499785 3871:15574759 3818:Archived 3813:Medscape 3766:17622089 3697:Archived 3647:15084238 3574:19454615 3538:Archived 3527:Archived 3507:28646773 3485:: 6–15. 3469:20956818 3391:Archived 3344:5 August 3338:Archived 3306:Archived 3290:14580242 3239:17993229 3171:Archived 3078:adjuvant 3075:systemic 3042:isoforms 2968:olaparib 2966:such as 2902:receptor 2899:estrogen 2872:fixative 2868:receptor 2865:estrogen 2767:adjuvant 2758:factor. 2740:formalin 2732:receptor 2729:estrogen 2646:receptor 2643:estrogen 2621:receptor 2618:estrogen 2567:clusters 2523:clusters 2479:HER2/neu 2474:HER2/neu 2436:dividing 2400:RB1 loss 2113:HER2/neu 2047:Receptor 2001:adjuvant 1991:such as 1963:estrogen 1951:receptor 1751:HER2/neu 1749:(ER) or 1703:Stage I 1695:Stage 0 1475:(DCIS), 1428:HER2/neu 1036:Mammary 963:Apocrine 947:Adenomas 933:adenosis 927:adenosis 921:adenosis 915:adenosis 912:Apocrine 908:adenosis 900:Adenosis 874:Central 803:Invasive 784:(benign) 651:Glycogen 491:tumours 473:columnar 421:features 237:HER2/neu 225:hormones 96:Overview 85:inflamed 34:proteins 7403:stromal 7371:Lobular 7257:Alcohol 7235:General 7178:5161065 7127:2938244 7078:2880419 7027:2768087 6773:2920208 6750:Bibcode 6695:2949642 6569:2841938 6546:Bibcode 6510:3002335 6493:: 300. 6417:2913123 6313:2376904 5863:2793754 5618:3913192 5528:2917037 5443:6255927 5400:1280204 5372:Bibcode 5285:3303043 5236:3286979 5044:5528267 4990:3076683 4941:3127435 4831:9534884 4780:16 June 4631:4000199 4397:9659859 4308:2217975 4267:3347753 3967:9568179 3930:2073885 3758:1757079 3689:3300383 3591:15 June 3535:Table 3 3524:Table 6 3460:5161058 3071:cohorts 3014:alleles 2944:taxanes 2940:tubulin 2532:genes, 2527:hormone 2448:S phase 2354:MAPK3K1 2121:Claudin 1995:and or 1410:Staging 1286:(HPFs) 1272:mitotic 1055:adenoma 1031:sarcoma 965:adenoma 959:adenoma 798:In situ 672:sarcoma 335:in situ 221:nucleus 171:staging 159:Grading 157:Grade. 83:by the 7515:Portal 7331:Ductal 7185: 7175: 7134: 7124: 7085: 7075: 7034: 7024: 6985: 6949: 6941: 6900: 6864: 6856: 6821: 6780: 6770: 6742:Nature 6702: 6692: 6651: 6576: 6566: 6517: 6507: 6466: 6424: 6414: 6366: 6320: 6310: 6125: 6083: 6042: 6022:Cancer 6001: 5924: 5870: 5860: 5818: 5774: 5724: 5716: 5668: 5660: 5625: 5615: 5576: 5535: 5525: 5484: 5476: 5441: 5433: 5398: 5390: 5364:Nature 5343: 5335: 5327: 5292: 5282: 5243: 5233: 5192: 5184: 5140: 5094: 5086: 5051: 5041: 4997: 4987: 4948: 4938: 4870: 4829: 4821: 4768: 4724:3 July 4665: 4629: 4404: 4394: 4306: 4265: 4187: 4074: 4066: 3965: 3937: 3927: 3869: 3791: 3764: 3756: 3719: 3686: 3645: 3638:400666 3635: 3572: 3505: 3497: 3467: 3457: 3417: 3407: 3288: 3281:314400 3278: 3237: 3227: 3034:HOXB13 3022:CYP2D6 2813:tumors 2780:, and 2736:tumors 2575:cancer 2547:tumors 2468:cancer 2452:ploidy 2351:PI3KCA 2234:types 1968:(ER), 1688:5-year 1587:RT-PCR 1560:apical 1368:>22 1365:>19 1362:>10 1294:Score 1183:cancer 1104:, and 1076: 1013:Benign 943:lesion 715:Lipoma 584:Mixed 494:Solid 231:(ER), 7475:Other 7425:Other 7323:Types 6947:S2CID 6862:S2CID 5954:(PDF) 5943:(PDF) 5722:S2CID 5666:S2CID 5482:S2CID 5439:S2CID 5396:S2CID 5341:S2CID 5190:S2CID 5092:S2CID 4896:8 May 4827:S2CID 4718:(PDF) 4711:(PDF) 3789:S2CID 3762:S2CID 3334:(FDA) 3330:U.S. 3116:Notes 2956:BRCA2 2952:BRCA1 2895:stage 2797:HER-2 2725:genes 2685:tumor 2681:genes 2669:grade 2571:genes 2519:genes 2357:GATA3 2094:BRCA1 2066:grade 2063:tumor 1879:1978 1876:1977 1865:1984 1862:1983 1851:1989 1848:1988 1837:1993 1834:1992 1823:1998 1820:1997 1809:2003 1806:2002 1795:2010 1792:2009 1706:100% 1698:100% 1685:Stage 1608:well. 1527:T4d: 1471:Tis: 1462:tumor 1405:Stage 1359:>8 1356:>7 1348:12-22 1345:10-19 1266:This 1172:genes 1158:This 1131:This 1087:Grade 790:(See 625:Lipid 548:Pure 509:tumor 475:cell 459:mucin 318:Ducts 118:(TNM) 115:stage 111:grade 38:genes 30:stage 26:grade 7183:PMID 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