![]() ![]() A registry analysis of 500 BCLM patients found HR positive breast cancer reduced the risk of death by 33 compared with HR negative breast cancer 7. ![]() This report constitutes a detailed outline of the findings and recommendations of the consensus conference group, organized according to structural guidelines as defined. Importantly, molecular subtypes are not only a risk factor for liver metastasis but also a predictor of clinical outcome of BCLM patients. For example, ER is a prognostic factor because of its association with outcomes but it is also a predictive factor in breast cancer since cancers with 1 ER expression by immunohistochemistry testing receive a statistically significant disease free and overall survival benefit when treated with hormone-targeted therapies such a tamoxifen or. Factors in category III included DNA ploidy analysis, microvessel density, epidermal growth factor receptor, transforming growth factor-alpha, bcl-2, pS2, and cathepsin D. Category II factors included c-erbB-2 (Her2-neu), proliferation markers, lymphatic and vascular channel invasion, and p53. Recommendations were based on the following aims: (1) increasing uniformity and completeness of pathologic evaluation of tumor specimens, (2) enhancing the quality of data collected about existing prognostic factors, and (3) improving patient care.įactors ranked in category I included TNM staging information, histologic grade, histologic type, mitotic figure counts, and hormone receptor status. Patients with MBC represent a heterogeneous group whose prognosis and outcome may be dependent on host factors. For each factor, detailed recommendations for improvement were made. Background: Treatment of metastatic breast cancer (MBC) remains palliative. The most useful prognostic factors are clinically based. Factors in categories I and II were considered with respect to variations in methods of analysis, interpretation of findings, reporting of data, and statistical evaluation. Although they can be separately classified, several factors in breast cancer are both prognostic and predictive (eg, the presence of over-expression of the human epidermal growth factor receptor 2). Under the auspices of the College of American Pathologists, a multidisciplinary group of clinicians, pathologists, and statisticians considered prognostic and predictive factors in breast cancer and stratified them into categories reflecting the strength of published evidence.įactors were ranked according to previously established College of American Pathologists categorical rankings: category I, factors proven to be of prognostic import and useful in clinical patient management category II, factors that had been extensively studied biologically and clinically, but whose import remains to be validated in statistically robust studies and category III, all other factors not sufficiently studied to demonstrate their prognostic value.
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