From Immunohistochemistry to New Digital Ecosystems: A State-of-the-Art Biomarker Review for Precision Breast Cancer Medicine
Abstract
:Simple Summary
Abstract
1. Introduction
2. Hormone Receptors (HR)
3. Human Epidermal Growth Factor Receptor 2 (HER2)
4. Ki67
5. TILs and PD-L1
6. Homologous Recombination
7. Mismatch Repair
8. Multigene Assays
9. Liquid Breast Cancer Biopsy
10. Diagnostic Molecular Markers
10.1. IDH Mutation in Tall Cell Carcinoma with Reverse Polarity
10.2. ETV6-NTRK3 Gene Fusions in Secretory Carcinoma
11. Whole Slide Imaging, Radiomics and Multi-Omic Machine Learning
12. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Markers | Comments |
---|---|
Anatomic factors (TNM) | |
Tumor (T) | Histologic type, grade, and size |
Regional lymph nodes (N) | Nodal metastasis (including the number of involved nodes). The presence of nodal metastases is correlated with the probability of distant metastasis |
Distant metastasis (M) | Metastasis beyond regional lymph nodes such as in organs like lung, bone, liver etc. Once distant metastases are present, a cure is unlikely, although long-term remissions and palliation can be achieved |
Prognostic factors | |
ER, PR, and HER2 | All invasive tumors are tested for ER, PR, and HER2 status using IHC and ISH (for HER2) |
Multigene Panels scores | Oncotype Dx recurrent score to identify patients with HR+, HER2- early stage breast cancer who can be spared the toxicity of chemotherapy |
Test Type | Score/ Group | Interpretation | Scoring Criteria (ASCO/CAP 2018) |
---|---|---|---|
IHC | Score 0 | Negative | No staining observed, or membrane stating that is incomplete and is faint/barely perceptible and in ≤10% of tumor cells |
Score 1+ | Negative | Incomplete membrane staining that is faint/barely perceptible and in >10% of tumor cells | |
Score 2+ | Equivocal | Weak to moderate complete membrane staining in >10% of tumor cells. Must order reflex test with ISH | |
Score 3+ | Positive | Circumferential membrane staining that is complete, intense and in >10% of tumor cells | |
ISH | Group 1 | Positive | HER2/CEP17 ratio ≥2.0; average HER2 signals/cell ≥4.0 |
Group 2 | Negative * | HER2/CEP17 ratio ≥2.0; average HER2 signals/cell <4.0 | |
Group 3 | Positive * | HER2/CEP17 ratio <2.0; average HER2 signals/cell ≥6.0 | |
Group 4 | Negative * | HER2/CEP17 ratio <2.0; average HER2 signals/cell ≥4.0 and <6.0 | |
Group 5 | Negative | HER2/CEP17 ratio <2.0; average HER2 signals/cell <4.0 |
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Hacking, S.M.; Yakirevich, E.; Wang, Y. From Immunohistochemistry to New Digital Ecosystems: A State-of-the-Art Biomarker Review for Precision Breast Cancer Medicine. Cancers 2022, 14, 3469. https://doi.org/10.3390/cancers14143469
Hacking SM, Yakirevich E, Wang Y. From Immunohistochemistry to New Digital Ecosystems: A State-of-the-Art Biomarker Review for Precision Breast Cancer Medicine. Cancers. 2022; 14(14):3469. https://doi.org/10.3390/cancers14143469
Chicago/Turabian StyleHacking, Sean M., Evgeny Yakirevich, and Yihong Wang. 2022. "From Immunohistochemistry to New Digital Ecosystems: A State-of-the-Art Biomarker Review for Precision Breast Cancer Medicine" Cancers 14, no. 14: 3469. https://doi.org/10.3390/cancers14143469