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.

2518: 7535: 3363: 2845:(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. 1918:

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.

1229: 192:(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: 3380: 1933:

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.

6112:"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" 1423:

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

3828: 250:. 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 187:

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.

1463:, 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. 74:

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.

1253: 2896:. 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 2532:. 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 1123:. 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. 55:

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.

2726:-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". 1285:

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:

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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".

3031:; 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 1565:), 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 2116:

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

390:(WHO) classification of tumors of the breast which includes benign (generally harmless) tumors and malignant (cancerous) tumors, recommends the following pathological types: 3072:

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

6453:"Phase II randomized study of neoadjuvant everolimus plus letrozole compared with placebo plus letrozole in patients with estrogen receptor-positive breast cancer" 2941:

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

6728: 7272: 7229: 6070:"Prospective multicenter study of the impact of the 21-gene recurrence score assay on medical oncologist and patient adjuvant breast cancer treatment selection" 2881:(ER) status. The test is run on formalin fixed, paraffin-embedded tissue. MammaPrint traditionally used rapidly frozen tissue but a room temperature, molecular 4164: 3589:. 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 1661:

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

316: 2800: 1915:. For example, differences in the 1998 and 2003 categories resulted in many cancers being assigned differently, with apparent improvement in survival rates. 6029:"Utility of oncotype DX risk estimates in clinically intermediate risk hormone receptor-positive, HER2-normal, grade II, lymph node-negative breast cancers" 612:(Other well-accepted subtypes of metaplastic mammary carcinoma thought to have clinical significance but not included in the decade old WHO classification: 457: 7013:"An investigation into the performance of the Adjuvant! Online prognostic programme in early breast cancer for a cohort of patients in the United Kingdom" 1557:

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

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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.

5512:"Genomic subtypes of breast cancer identified by array-comparative genomic hybridization display distinct molecular and clinical characteristics" 3336: 2674:

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

5988:"Gene expression profiles in paraffin-embedded core biopsy tissue predict response to chemotherapy in women with locally advanced breast cancer" 7502: 6847:

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

6606: 3731: 3419: 3239: 2819: 2815: 2639: 2635: 1949: 1942: 870: 704: 545: 7162:"Choosing Treatment for Patients With Ductal Carcinoma In Situ: Fine Tuning the University of Southern California/Van Nuys Prognostic Index" 6808:"Tamoxifen-induced ER-alpha-SRC-3 interaction in HER2 positive human breast cancer; a possible mechanism for ER isoform specific recurrence" 4725: 5563:"Defining the clinical utility of gene expression assays in breast cancer: the intersection of science and art in clinical decision making" 4490: 2776:

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.

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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

7399: 7354: 1491: 1080: 1069: 474: 196: 147:, the considerable majority of breast cancers are derived from the epithelium lining the ducts or lobules, and are classified as 5220:"Breast Cancer Special Feature: Comparative oncogenomics identifies breast tumors enriched in functional tumor-initiating cells" 4784: 3707: 7575: 7570: 3316: 7113:"BCL2 in breast cancer: a favourable prognostic marker across molecular subtypes and independent of adjuvant therapy received" 3595: 7262: 4455:"American Joint Committee on Cancer: Publications & Electronic Products: Past Editions of the AJCC Cancer Staging Manual" 3056: 6279: 4927:"Identification of human triple-negative breast cancer subtypes and preclinical models for selection of targeted therapies" 4203: 2738:

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 (

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

2553: 2100: 2035: 251: 162: 6346: 6222: 4240: 3916:"Histological grading and prognosis in breast cancer; A study of 1409 cases of which 359 have been followed for 15 years" 3003:

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

1119:, each of which is given 1 to 3 points. The scores for each of these three criteria are then added together to give an 157:

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

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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/

5899: 3819:"What is the Nottingham combined histologic grade (modified Scarff-Bloom-Richardson grade) system for breast tumors?" 2922:, but internationally the test may be performed if the lymph node status is negative or positive with up to 3 nodes. 1475:

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

5849:"American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer" 4161: 2985:(6TG) may overcome the resistance that can arise in BRCA cancers to PARP inhibitors or platinum-based chemotherapy. 7525: 7457: 7442: 7394: 7314: 6027:

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

1539: 672: 492: 442: 369: 87: 7555: 7389: 7324: 7267: 5761:"Prediction of adjuvant chemotherapy benefit in endocrine responsive, early breast cancer using multigene assays" 2034:, (in combination with conventional chemotherapy) and this has improved the prognosis significantly. Conversely, 1938: 1487: 1189:

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 (

841: 387: 368:, representing about 80% of invasive carcinomas. In the US, 55% of breast cancers are invasive ductal carcinoma. 365: 7409: 7366: 7349: 7306: 7296: 3559:"The changing incidence of in situ and invasive ductal and lobular breast carcinomas: United States, 1999–2004" 3120: 2605: 2135: 1926:

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

1483: 865: 709: 651: 588: 288: 214: 200: 148: 6200: 2134:-low: a more recently described class; often triple-negative, but distinct in that there is low expression of 6603: 7565: 7492: 7289: 7284: 6623: 2703: 2667: 2649: 2624: 2601: 2597: 2593: 2540: 2057: 1961: 1178: 583: 569: 415: 223: 63: 6257: 1154:

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

7560: 5961: 5756: 4896: 3021: 2969: 2841:. Oncotype fulfilled all California Technology Assessment Forum (CTAF) criteria in October 2006. The U.S. 1998:

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

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

254:. HER2-low has some HER2 proteins on the cell surface, but not enough to be classified as HER2-positive. 7447: 7371: 7062:"PREDICT: a new UK prognostic model that predicts survival following surgery for invasive breast cancer" 6747:

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

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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 (

1562: 1434: 880: 656: 402: 243: 6494:"Epigenetic control of the basal-like gene expression profile via Interleukin-6 in breast cancer cells" 6401:

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

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

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

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

17: 6760: 6556: 5382: 3533:

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

2882: 2562: 2497: 2304: 2019: 1969: 1590: 951: 916: 825: 737: 530: 506: 62:

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).

3991: 3545: 3534: 2835: 2496:(FISH) assays. Some commentators prefer this approach, claiming a higher correlation than receptor 1028: 979: 667: 646: 641: 364:

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

324: 7452: 6957: 6872: 5732: 5676: 5492: 5449: 5406: 5351: 5200: 5102: 4837: 4718: 4452:

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

4219: 3799: 3772: 2620: 2548: 2474: 1753: 1460: 802: 699: 524: 487: 479: 336: 177: 6451:

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

6403:"6-thioguanine selectively kills BRCA2-defective tumors and overcomes PARP inhibitor resistance" 6297:"DNA topoisomerase II alfa expression and the response to primary chemotherapy in breast cancer" 4543:

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

372:

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

90:(IBC), a form of ductal carcinoma or malignant cancer in the ducts, is distinguished from other 6926:

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

5895:

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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7032: 7024: 6985: 6939: 6900: 6856: 6819: 6778: 6768: 6700: 6690: 6651: 6574: 6564: 6515: 6505: 6464: 6422: 6414: 6366: 6318: 6308: 6123: 6081: 6040: 5999: 5924: 5868: 5860: 5816: 5772: 5714: 5660: 5623: 5615: 5574: 5533: 5523: 5476: 5433: 5390: 5327: 5290: 5282: 5271:"Genomic analysis identifies unique signatures predictive of brain, lung, and liver relapse" 5241: 5231: 5182: 5138: 5086: 5049: 5041: 4995: 4987: 4946: 4938: 4925:

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

4768: 4665: 4629: 4402: 4392: 4304: 4265: 4064: 3935: 3927: 3867: 3791: 3756: 3694: 3684: 3643: 3633: 3570: 3497: 3465: 3457: 3286: 3276: 3265:"Inflammatory breast cancer: Clinical progress and the main problems that must be addressed" 3227: 3149: 2942: 2242: 1999: 1566: 1542:, a clinical circumstance where typical skin changes involve at least a third of the breast. 1294: 1018: 762: 354: 328: 3014:(LRP6) may represent a distinct subtype of breast cancer and a potential treatment target. 7539: 7426: 7413: 7361: 6679:"Predictive relevance of HOXB13 protein expression for tamoxifen benefit in breast cancer" 6630: 6610: 6545:"LRP6 overexpression defines a class of breast cancer subtype and is a target for therapy" 6283: 6264: 6245: 6226: 6207: 6185: 6178: 6159: 5903: 4608: 4589: 4570: 4563: 4551: 4544: 4532: 4525: 4513: 4506: 4494: 4458: 4344: 4324: 4244: 4231: 4168: 4142: 3711: 3622:"Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome" 3405: 3320: 3085: 2996: 2974: 2577: 2569:) more reliably assorts particular cancers to effective therapies is under investigation. 2566: 2533: 2525: 2088: 1608: 962: 429: 373: 358: 6275:

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

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4293:"Internal mammary lymphadenopathy: imaging of a vital lymphatic pathway in breast cancer" 82:

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

6764: 6560: 6238: 5386: 4601: 4582: 2915:

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

2822:(NCCN). The NCCN Panel considers the 21-gene assay as an option when evaluating certain 2038:(i.e. no positive receptors), lacking targeted treatments, now has a comparatively poor 98:

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

7472: 7381: 7341: 7188: 7161: 7137: 7112: 7088: 7061: 7037: 7012: 6928:"Population-based validation of the prognostic model ADJUVANT! for early breast cancer" 6783: 6705: 6678: 6579: 6544: 6520: 6493: 6427: 6402: 6323: 5873: 5848: 5628: 5603: 5538: 5511: 5295: 5270: 5246: 5054: 5029: 5000: 4975: 4951: 4926: 4719:"National Comprehensive Cancer Network (NCCN) guidelines, Breast Cancer Version 2.2011" 4407: 4380: 4309: 4292: 3940: 3915: 3854:, Schraml P, Torhorst J, Tapia C, Zaharieva B, Novotny H, et al. (December 2004). 3760: 3699: 3672: 3470: 3445: 3018: 2901: 2889: 2687: 2573: 2442: 1988: 1912: 1420: 1058: 777: 574: 499: 181: 144: 32: 6989: 5777: 5760: 3648: 3621: 3291: 3264: 2830:, emphasizing that the recurrence score should be used along with other breast cancer 7549: 7277: 7252: 7238: 5928: 5355: 5318:

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

2589: 2080: 1965: 350: 113: 83: 28: 7178: 6961: 6876: 5986:

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

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

5736: 5719: 5702: 5680: 5496: 5204: 5106: 4381:"Five-year relative survival by stage of breast and colon cancers in northern Italy" 4269: 4051:

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3776: 3461: 3313: 2477:. In contrast, modern DNA analyses are increasingly relevant in defining underlying 1756:

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

1577:

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

7421: 6068:

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

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4135: 3856:"Prognostic relevance of gene amplifications and coamplifications in breast cancer" 3081: 2827: 2788: 2780: 2762: 2757:, referring to the likelihood of recurrence without treatment. In addition to that 2117: 1174: 1013: 792: 767: 752: 742: 714: 694: 231: 95: 79: 78:

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

6418: 4991: 4873: 4856: 4600:

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

3872: 3855: 3575: 3558: 1586: 51:. As knowledge of cancer cell biology develops these classifications are updated. 6749:"Regulation of ERBB2 by oestrogen receptor-PAX2 determines response to tamoxifen" 6276: 5331: 5187: 5170: 5045: 4976:"Androgen receptor expression and breast cancer survival in postmenopausal women" 2993:

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

7497: 5701:

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

4633: 4187: 4162:

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

3231: 3000: 2946: 2784: 2711: 2584:

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

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

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

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

1573:) axilla which is above the pectoralis minor muscle. Each stage is as follows: 320:

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

7319: 6904: 6860: 6219: 5370: 5286: 5090: 4379:

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

4237: 2990: 2930: 2916: 2893: 2864: 2854: 2773: 2766: 2761:

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

2758: 2719: 2715: 2645: 2616:

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

2470: 2466: 2143: 2139: 1987:. This remains the most common method of testing for receptor status, but DNA 1930: 1554: 1186: 747: 689: 603: 596: 578: 563: 560: 553: 422: 302: 301:

Familial breast cancers may potentially undergo dissimilar treatment (such as

210: 6677:

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

6469: 6452: 6370: 6086: 6069: 6004: 5987: 5864: 5619: 5579: 5562: 5339: 4857:"Triple-negative breast cancer: clinical features and patterns of recurrence" 4397: 4078: 4069: 4052: 3509: 3429: 3039:

polymorphism gave counterintuitive results. The medical utility of potential

6944: 6927: 6569: 6510: 6128: 6111: 5236: 5219: 4669: 4101:"Infiltrating Ductal Carcinoma of the Breast (Carcinoma of No Special Type)" 3172:"Infiltrating Ductal Carcinoma of the Breast (Carcinoma of No Special Type)" 3104: 3073: 3028: 2754: 2450: 2084: 2039: 2023: 2015: 2003: 1425: 1398: 1278: 1170: 1160:

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

1143: 1063: 1048: 1033: 967: 886: 798: 772: 517: 510: 294:

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

281: 227: 91: 71: 59: 7197: 7146: 7128: 7097: 7046: 7028: 6997: 6953: 6912: 6868: 6833: 6792: 6714: 6663: 6588: 6529: 6478: 6436: 6378: 6332: 6313: 6296: 6137: 6095: 6054: 6013: 5936: 5882: 5830: 5786: 5728: 5703:"Commercialized Multigene Predictors of Clinical Outcome for Breast Cancer" 5672: 5637: 5588: 5547: 5488: 5445: 5402: 5347: 5304: 5255: 5196: 5152: 5098: 5063: 5009: 4960: 4882: 4833: 4780: 4677: 4416: 4199: 4086: 3949: 3881: 3657: 3584: 3557:

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

3517: 3479: 3300: 3249: 3219:"Overview of Resistance to Systemic Therapy in Patients with Breast Cancer" 2874:. The commercial test is marketed for use in breast cancer irrespective of 2060:

status was traditionally considered by reviewing each individual receptor (

1437:

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

284:

and present visually appealing graphics that assist in treatment decisions.

66:. Classification aspects must be carefully tested and validated, such that 6604:

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

6201:

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

5896: 4772: 4641: 4318: 4277: 3977: 3768: 3724:

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

2885:

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

1658:

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

6624:

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

5821: 5804: 5424:

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

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power was less substantial than other classification schemes such as the

2123: 2011: 1973: 1761: 1438: 973: 943: 937: 931: 925: 922: 910: 661: 483: 331:

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

247: 6824: 6807: 6773: 6748: 6258:

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

4486:

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

3931: 3123:(DCIS) into dissimilar risk categories that may be treated accordingly. 6655: 6045: 6028: 5604:"Predictive biomarker validation in practice: lessons from real trials" 3617:

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

3036: 3024: 2973:

receptor triple negative breast cancers, may respond to treatment with

2950: 2537: 2521:

Molecular classification of breast cancer from mRNA expression profiles

2458: 2446: 2131: 2072:) in turn, but newer approaches look at these together, along with the 1282: 1041: 957: 808: 682: 345: 335:

Histopathologic classification is based upon characteristics seen upon

291:(DCIS) into dissimilar risk categories that may be treated accordingly. 235: 44: 5805:"Concordance among gene-expression-based predictors for breast cancer" 5480: 5437: 4134:

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

1764:

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

5394: 4942: 3044: 3032: 2954: 2796: 2585: 2478: 2462: 1597: 1558: 1197: 1193: 1023: 725: 7078: 6806:

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

6695: 6256:

MammaPrint Patient Eligibility Internationally (Outside of the USA)

5528: 3155:

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

1570: 3689: 3638: 3281: 2504:, a targeted therapy, but guidelines permit either testing method. 2966: 2962: 2826:

to assist in estimating likelihood of recurrence and benefit from

2823: 2807: 2746: 2695: 2557: 2516: 2104: 2073: 1472: 1268: 1157:

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

635: 469: 3366:

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

262:(FDA) targeted to people with the HER2-low breast cancer subtype. 7207: 3337:"FDA Approves First Targeted Therapy for HER2-Low Breast Cancer" 3108: 3048: 3011: 2986: 2860: 2838: 2735: 2723: 2699: 2691: 2581: 2544: 2529: 2454: 2069: 2027: 1984: 1900: 1404:

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

1204:

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

1182: 1150:

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

48: 7211: 4160:

National Cancer Institute. Stage Information for Breast Cancer.

3017:

Numerous clinical investigations looked at whether testing for

2439: 2083:

into several conceptual molecular classes that have different

1654:

M0: No clinical or radiographic evidence of distant metastases

1441:) status, menopausal status, and the person's general health. 1247:

Invasive lobular carcinoma with moderate nuclear pleomorphism.

831:

Metastatic tumors to the breast from other places in the body

270: 266: 4488:

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

3216:

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

2904:, a breast cancer should have the following characteristics: 1235:

Invasive ductal carcinoma with moderate nuclear pleomorphism.

5127:"Molecular Stratification of Triple-Negative Breast Cancers" 2981:. Combining these newer medicines with older agents such as 393: 7011:

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

3673:"Ductal carcinoma in situ (DCIS): are we overdetecting it?" 3027:

of several genes could predict whether or not to prescribe

1407:

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

1259:

Invasive ductal carcinoma with marked nuclear pleomorphism.

6543:

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

4897:"Understanding and Treating Triple-Negative Breast Cancer" 1207:

2 points: nuclei with moderate variation in size and shape

339:

of biopsy specimens. They can broadly be classified into:

143:

Histopathology. Although breast cancer has many different

5030:"Deconstructing the molecular portraits of breast cancer" 3592:"ACS :: Breast Cancer Facts & Figures 2003-2004" 2445:

was based on the general observation that cells that are

206:

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

199:. Stage 0 is a pre-cancerous or marker condition, either 6237:

Ordering Symphony is a simple process. Agendia web site.

2949:

is relatively useful. Expression of genes that regulate

2330:

Progesterone receptor positive in less than 20% of cases

2087:

and may have different responses to specific therapies.

1210:

3 points: nuclei with marked variation in size and shape

135:, and the presence or absence of genes as determined by 6179:

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

4564:

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

4545:

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

4526:

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

4507:

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

4325:

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

4323:

available as full text article with multiple images at

2314:

Progesterone receptor positive in at least 20% of cases

1972:(IHC), which stains the cells based on the presence of 448:

Classic Solid Mixed Alveolar Tubulolobular Pleomorphic

6731:. CORDIS : News. 13 November 2008. Archived from 4238:

Creative Commons Attribution 4.0 International License

2604:, which is rigorously defined as being derived from a 2010:. These treatments are now some of the most effective 7523: 6239:

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

4713: 4711: 4709: 4707: 4602:

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

4583:

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

4291:

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

2859:

The MammaPrint gene pattern is a commercial-stage 70-

4705: 4703: 4701: 4699: 4697: 4695: 4693: 4691: 4689: 4687: 3450:

Journal of the National Cancer Institute. Monographs

3119:

The USC/Van Nuys prognostic index (VNPI) classifies

630:

Metaplastic carcinoma with osteoclastic giant cells)

287:

The USC/Van Nuys prognostic index (VNPI) classifies

7485: 7435: 7408: 7380: 7340: 7333: 7305: 7245: 2925:One method of assessing the molecular subtype of a 2634:(ER) positive tumors, and has been endorsed by the 2461:. These methods, and scoring systems that used DNA 2151:Comparison of molecular subtypes of breast cancer. 1611:, or macrometastasis on sentinel lymph node biopsy. 468:Mucinous carcinoma and other tumours with abundant 3620:Arpino G, Bardou VJ, Clark GM, Elledge RM (2004). 3217: 3012:low-density lipoprotein receptor-related protein 6 161:invades the surrounding tissue. Perineural and/or 7160:Silverstein Melvin J., Lagios Michael D. (2010). 6391:Tutt A J Clin Onc 2009; 27(suppl 15): abst CRA501 4130: 4128: 2547:-related genes, a group of basal-like genes, and 2350:HER2, estrogen and progesterone receptor negative 2091:have assisted this approach, as discussed in the 1945:sites which reprints these with AJCC permission. 6173: 6171: 6169: 6167: 4136:http://www.cancerstaging.org/mission/whatis.html 1691:Breast cancer prognosis by stage 1223:Ductal carcinoma with mild nuclear pleomorphism. 6729:"Study sheds new light on tamoxifen resistance" 6549:Proceedings of the National Academy of Sciences 5224:Proceedings of the National Academy of Sciences 4373: 4371: 4180: 4178: 4176: 2453:, and relied on either the presence of protein 1138:Tubule formation score in the Nottingham system 357:programs. These have favorable prognosis, with 6277:http://www.agendia.com/pages/blueprint/324.php 6195: 6193: 4920: 4918: 3412:Robbins and Cotran pathologic basis of disease 3331: 3329: 1397:3-5 Grade 1 tumor (well-differentiated). Best 7223: 5842: 5840: 5750: 5748: 5746: 5371:"Molecular portraits of human breast tumours" 3394: 3392: 3390: 3388: 2186:Compared to Luminal A, higher expression of: 1992: 353:, more so in countries with high coverage of 8: 5120: 5118: 5116: 4429:: CS1 maint: multiple names: authors list ( 4156: 4154: 4152: 4150: 3051:, and estrogen receptor (ER) alpha and beta 2099:Basal-like: ER-, PR- and HER2-; also called 1626:N2: Fixed/matted ipsilateral axillary nodes. 6220:http://www.agendia.com/pages/mission/86.php 5696: 5694: 5692: 5690: 5164: 5162: 5023: 5021: 5019: 4482: 4480: 4478: 4476: 4338: 4336: 4334: 4332: 4057:Journal of Cancer Research and Therapeutics 3161:Nikon or Olympus with 10x eyepiece: 0.16 mm 2795:found a strong correlation of the Oncotype 2659:(ER) positive and negative tumors, and has 2343:Estrogen and progesterone receptor negative 1121:overall final score and corresponding grade 460:(also termed invasive cribriform carcinoma) 458:Invasive cribriform carcinoma of the breast 203:(DCIS) or lobular carcinoma in situ (LCIS). 7337: 7230: 7216: 7208: 6218:The mission of Agendia. Agendia web isite. 5798: 5796: 4750: 4748: 4746: 3726:. Oxford : Oxford University Press. 2003. 3529: 3527: 3446:"Epidemiology of ductal carcinoma in situ" 3111:has shown promise in preliminary studies. 2908:1 or 2, tumor size less than 5.0 cm, 2481:biology and in helping choose treatments. 2142:and frequently there is infiltration with 1778: 1689: 1181:). In cancer, the mechanisms that control 7273:Hereditary breast–ovarian cancer syndrome 7187: 7177: 7136: 7087: 7077: 7036: 6943: 6823: 6782: 6772: 6704: 6694: 6578: 6568: 6519: 6509: 6468: 6426: 6322: 6312: 6127: 6085: 6044: 6003: 5872: 5820: 5776: 5718: 5627: 5602:Mandrekar SJ, Sargent DJ (October 2010). 5578: 5537: 5527: 5294: 5245: 5235: 5186: 5142: 5053: 4999: 4950: 4872: 4823: 4448: 4446: 4444: 4442: 4440: 4406: 4396: 4308: 4068: 3939: 3871: 3698: 3688: 3647: 3637: 3574: 3469: 3290: 3280: 2627:, and was originally designed for use in 2465:, are used much less often now, as their 2026:. Generally, prior to modern treatments, 1670:A combination of T, N and M, as follows: 1112: 627:Squamous cell carcinoma of mammary origin 349:. This group constitutes about 15-30% of 4755:Sotirou Christos, Pusztai Lajos (2009). 4186:Fadi M. Alkabban; Troy Ferguson (2021). 2937:Other DNA assays and choice of treatment 2457:or the percentage of cancer cell DNA in 2149: 2122:ERBB2/HER2-amplified: has overexpressed 2018:) or the actual level of estrogen (e.g. 1923:historical expectations for that stage. 1680:Stage II: T2N0, T3N0 T0N1, T1N1, or T2N1 1639:N3b – Ipsilateral internal mammary nodes 1291: 1133: 323: 315: 258:is the first approved therapy by the US 7530: 5951:"Select your country: Qiagen Marseille" 5917:Critical Reviews in Oncology/Hematology 5897:http://www.emaxhealth.com/98/22731.html 4343:Joseph A Sparano, MD (6 October 2021). 3414:. Philadelphia, PA: Saunders/Elsevier. 3379:References for pie chart is located at 3208: 3132: 2734:Oncotype DX assesses 16 cancer-related 2095:. Proposed molecular subtypes include: 1642:N3c – Ipsilateral supraclavicular nodes 1636:N3a – Ipsilateral infraclavicular nodes 1213: 136: 70:are minimized, making them either true 7503:National Breast Cancer Awareness Month 4422: 4355:from the original on 13 September 2020 4227: 4217: 4113:from the original on 11 September 2019 4106:Stanford University School of Medicine 3914:Bloom, H.J.; Richardson, W.W. (1957). 3184:from the original on 11 September 2019 3177:Stanford University School of Medicine 3144: 3142: 3140: 3138: 3136: 2803:(CR) to the presurgical chemotherapy. 2279:Pleomorphic invasive lobular carcinoma 2269:Pleomorphic invasive lobular carcinoma 18:Bloom–Richardson–Elston grading system 4206:from the original on 24 December 2020 4032:from the original on 8 September 2020 4022:"Metaplastic Carcinoma of the Breast" 4002:from the original on 8 September 2020 3831:from the original on 30 November 2020 2820:National Comprehensive Cancer Network 2816:American Society of Clinical Oncology 2814:Oncotype DX has been endorsed by the 2636:American Society of Clinical Oncology 2210:High expression of HER2-related genes 1968:has traditionally been identified by 1943:National Comprehensive Cancer Network 1196:areas having cells with the greatest 1126:The grading criteria are as follows: 1108: 705:Pseudoangiomatous stromal hyperplasia 546:Pure apocrine carcinoma of the breast 27:Breast cancer classification divides 7: 5275:Breast Cancer Research and Treatment 3043:of tamoxifen responsiveness such as 2945:(TOP2A) expression predicts whether 2892:using MammaPrint is included in the 2683: 2286:High grade invasive ductal carcinoma 2276:High grade invasive ductal carcinoma 2092: 1686:Stage IV: M1, advanced breast cancer 1273:Mitosis appearances in breast cancer 195:Stage 0 which is in situ disease or 132: 43:of the tumor, and the expression of 5561:Sparano JA, Solin LJ (April 2010). 4812:The New England Journal of Medicine 4787:from the original on 5 January 2010 4761:The New England Journal of Medicine 3992:"Medullary Carcinoma of the Breast" 3263:Giordano SH, Hortobagyi GN (2003). 2253:Low grade invasive ductal carcinoma 2113:Luminal B: ER+ but often high grade 2107:breast cancers are basal-like TNBC. 1952:; for past editions refer to AJCC. 805:section on types of breast cancer) 117: 4731:from the original on 24 March 2009 4310:10.1148/radiographics.10.5.2217975 3761:10.1111/j.1365-2559.1991.tb00229.x 3351:from the original on 6 August 2022 3314:Merck Manual, Professional Edition 3059:have all yet to be fully defined. 2256:Classic invasive lobular carcinoma 2213:Low expression of ER-related genes 1457:International Union Against Cancer 1453:American Joint Committee on Cancer 1120: 1116: 848:Intraductal proliferative lesions 721:Inflammatory myofibroblastic tumor 410:The remainder are given subtypes: 407:Most are "not otherwise specified" 25: 7513:List of people with breast cancer 4931:Journal of Clinical Investigation 3563:Cancer Epidemiol. Biomarkers Prev 3485:Lobular carcinoma in situ: 97% - 3381:Image description page in commons 2953:may help predict the activity of 2600:. No tests have been verified by 2494:fluorescent in-situ hybridization 1929:Previous editions featured three 1479:TX: inability to assess that site 871:Apocrine ductal carcinoma in situ 542:Invasive micropapillary carcinoma 464:Medullary carcinoma of the breast 435:Carcinoma with melanotic features 277:Other classification approaches. 116:. A full classification includes 7533: 7400:Hereditary lobular breast cancer 7395:Invasive lobular carcinoma (ILC) 7390:Lobular carcinoma in situ (LCIS) 6622:accessioned 2010 December 17 at 5929:10.1016/j.critrevonc.2010.01.011 5144:10.1634/theoncologist.2011-S1-61 4903:from the original on 9 June 2010 3796:10.1046/j.1365-2559.2002.14892.x 3442:Ductal carcinoma in situ: 99% - 3361: 3347:(Press release). 5 August 2022. 3103:tests that may further stratify 2694:, they seem to classify a given 2397:HER2 amplicon and corresponding 1252: 1240: 1228: 1216: 550:Apocrine-like invasive carcinoma 475:Mucinous carcinoma of the breast 7448:Metaplastic breast cancer (MBC) 7367:Invasive ductal carcinoma (IDC) 7350:Ductal carcinoma in situ (DCIS) 5809:New England Journal of Medicine 5720:10.1634/theoncologist.2007-0248 5028:Prat, A.; Perou, C. M. (2011). 4622:New England Journal of Medicine 4270:10.1148/radiology.167.1.3347753 3095:Other immunohistochemical tests 3063:Other classification approaches 2666:Two other tests also only have 2022:), and generally have a better 1076:Malignant tumors of the nipple 900:Intracystic papillary carcinoma 897:Intraductal papillary carcinoma 881:Intraductal papillary neoplasms 217:has a less favorable prognosis. 128: 5320:Advances in Anatomic Pathology 5175:Advances in Anatomic Pathology 3224:Breast Cancer Chemosensitivity 2722:information for patients with 2572:Several commercially marketed 2554:triple-negative breast cancers 2434:Traditional DNA classification 2420:PI3K/AKT pathway oversignaling 2221:Basal epithelial-related genes 1989:multi-gene expression profiles 681:Mesenchymal tumors (including 234:. Chemical messengers such as 226:on their surface and in their 1: 7508:Epidemiology of breast cancer 7355:Paget's disease of the breast 7179:10.1093/jncimonographs/lgq040 6990:10.1016/S1470-2045(09)70254-2 6419:10.1158/0008-5472.CAN-09-3416 5778:10.1016/S0960-9776(09)70290-5 4992:10.1158/1078-0432.CCR-10-2021 4874:10.1158/1078-0432.CCR-06-3045 3873:10.1158/0008-5472.CAN-04-1945 3576:10.1158/1055-9965.EPI-08-1082 3462:10.1093/jncimonographs/lgq027 3158:AO with 10x eyepiece: 0.12 mm 2831: 2765:, which is termed a positive 2690:look at different individual 2675: 2588:. The use of these assays in 2101:triple negative breast cancer 1893:AJCC; original pages 101-108 1879:AJCC; original pages 127-134 1865:AJCC; original pages 145-150 1851:AJCC; original pages 149-154 1837:AJCC; original pages 171-180 1823:AJCC; original pages 223-240 197:Paget's disease of the nipple 163:lymphovascular space invasion 6932:Journal of Clinical Oncology 6893:Journal of Clinical Oncology 6457:Journal of Clinical Oncology 6359:Journal of Clinical Oncology 6074:Journal of Clinical Oncology 5992:Journal of Clinical Oncology 5853:Journal of Clinical Oncology 5567:Journal of Clinical Oncology 5332:10.1097/PAP.0000000000000232 5188:10.1097/PAP.0b013e3181a9d4bf 5046:10.1016/j.molonc.2010.11.003 4658:Journal of Clinical Oncology 3343:Food and Drug Administration 2843:Food and Drug Administration 2676:breast cancer classification 2110:Luminal A: ER+ and low grade 1054:Benign tumors of the nipple 538:Invasive papillary carcinoma 260:Food and Drug Administration 222:Receptor status. Cells have 184: 7466:Atypical ductal hyperplasia 4634:10.1056/NEJM198506203122504 3232:10.1007/978-0-387-74039-3_1 3222:. In Yu D, Hung MC (eds.). 3152:for some microscope types: 2610:randomized controlled trial 2390:FOXM1-related transcription 2333:HER2 positive or high Ki-67 2224:proliferation-related genes 2189:Proliferation-related genes 2136:cell-cell junction proteins 1563:supraclavicular lymph nodes 1529:T4a: Chest wall involvement 997:Adenomyoepithelial adenosis 861:Atypical ductal hyperplasia 857:Flat epithelial hyperplasia 398:Invasive breast carcinomas 64:the best evidence available 7592: 7458:Inflammatory breast cancer 7443:Medullary breast carcinoma 7315:Breast cancer chemotherapy 6849:Expert Opin. Ther. Targets 5665:10.1038/nrclinonc.2010.142 4236:Last Update: 4 June 2019. 3502:10.1016/j.ejca.2017.05.030 3490:European Journal of Cancer 3006:Tumors overexpressing the 2919: 2905: 2871: 2852: 2679: 2492:status can be analyzed by 2449:more quickly have a worse 2377:Similar to luminal A but: 2327:Estrogen receptor positive 2311:Estrogen receptor positive 2076: 1919:use in the investigation. 1540:Inflammatory breast cancer 906:Benign epithelial lesions 788:Tumors of the male breast 677:Bilateral breast carcinoma 664:-rich clear cell carcinoma 618:Matrix-producing carcinoma 493:Signet ring cell carcinoma 443:Invasive lobular carcinoma 370:Invasive lobular carcinoma 169: 125: 121: 88:inflammatory breast cancer 40: 36: 7325:Breast-conserving surgery 7166:J Natl Cancer Inst Monogr 7117:British Journal of Cancer 6905:10.1200/JCO.2001.19.4.980 6861:10.1517/14728220902911509 6301:British Journal of Cancer 5902:29 September 2011 at the 5755:Albain, K. S.; Paik, S.; 5287:10.1007/s10549-011-1619-7 5091:10.1080/00313020802563536 4607:28 September 2011 at the 4588:28 September 2011 at the 4569:28 September 2011 at the 4550:28 September 2011 at the 4531:28 September 2011 at the 4512:28 September 2011 at the 3920:British Journal of Cancer 3410:Robbins, Stanley (2010). 3323:, Ch. 253, Breast Cancer. 3115:Van Nuys prognostic index 3080:Adjuvant! is based on US 2799:with the likelihood of a 2670:: Theros and MapQuant Dx. 2387:Myc-related transcription 2263:Invasive ductal carcinoma 1939:National Cancer Institute 1793:link(s) and page numbers 1519:T3: Larger than 5 cm 1488:lobular carcinoma in situ 1304: 1301: 842:lobular carcinoma in situ 388:World Health Organization 366:invasive ductal carcinoma 6470:10.1200/JCO.2008.18.8391 6371:10.1200/JCO.2009.25.4011 6282:3 September 2011 at the 6225:23 November 2013 at the 6206:22 December 2010 at the 6087:10.1200/JCO.2008.20.2119 6005:10.1200/JCO.2005.02.0818 5865:10.1200/JCO.2007.14.2364 5620:10.1177/1740774510368574 5580:10.1200/JCO.2009.25.2882 4980:Clinical Cancer Research 4861:Clinical Cancer Research 4398:10.3389/fonc.2022.982461 4243:21 November 2015 at the 4070:10.4103/0973-1482.140979 3121:ductal carcinoma in situ 2849:MammaPrint and BluePrint 2706:predictions of outcome. 2702:groups and thus provide 2688:gene-expression profiles 2297:Adenoid cyctic carcinoma 2266:Micropapillary carcinoma 2200:Luminal epithelial genes 2178:Luminal epithelial genes 2172:Overall gene expression 1549:Regional Lymph Nodes (N) 1484:ductal carcinoma in situ 1009:Fibroepithelial tumours 1005:Malignant myoepithelioma 866:Ductal carcinoma in situ 652:Adenoid cystic carcinoma 589:Mucoepidermoid carcinoma 531:neuroendocrine carcinoma 289:ductal carcinoma in situ 215:Metastatic breast cancer 201:ductal carcinoma in situ 149:mammary ductal carcinoma 7493:Breast cancer awareness 6945:10.1200/JCO.2005.06.178 6570:10.1073/pnas.0911220107 6511:10.1186/1476-4598-9-300 5237:10.1073/pnas.1018862108 4670:10.1200/JCO.2003.03.052 4345:"Breast Cancer Staging" 4184:Originally copied from 3444:Kerlikowske, K (2010). 3164:Leitz Ortholux: 0.27 mm 2902:gene expression profile 2894:MammaPrint main article 1496:T1: Less than 2 cm 877:Microinvasive carcinoma 584:Adenosquamous carcinoma 570:Squamous cell carcinoma 7576:Classification systems 7571:Medical classification 7129:10.1038/sj.bjc.6605736 7066:Breast Cancer Research 7029:10.1038/sj.bjc.6605283 6683:Breast Cancer Research 6609:11 August 2011 at the 6314:10.1038/sj.bjc.6601185 5516:Breast Cancer Research 4867:(15 Pt 1): 4429–4434. 4141:27 August 2013 at the 3841:Updated: 20 March 2019 3677:Breast Cancer Research 3167:Leitz Diaplan: 0.31 mm 2652:, can be performed on 2567:DNA expression profile 2522: 2036:triple negative cancer 1981:progesterone receptors 1649:Distant Metastases (M) 1553:Lymph Node – The 1274: 1198:cellular abnormalities 1139: 990:Myoepithelial lesions 950:Radial scar / complex 673:Inflammatory carcinoma 621:Spindle cell carcinoma 332: 321: 256:Trastuzumab deruxtecan 118:histopathological type 7372:Intraductal papilloma 6812:Endocr. Relat. Cancer 6158:28 March 2012 at the 6129:10.1093/annonc/mdr278 5125:Perou, C. M. (2011). 4773:10.1056/NEJMra0801289 3404:6 August 2022 at the 3008:Wnt signaling pathway 2749:. The test is run on 2648:is supported only by 2520: 2289:Metaplastic carcinoma 2196:Lower expression of: 1748:Staging and prognosis 1532:T4b: Skin involvement 1435:progesterone receptor 1293:Mitotic count per 10 1272: 1200:should be evaluated. 1173:assesses whether the 1137: 913:, including variants 657:Acinic cell carcinoma 327: 319: 244:progesterone receptor 6184:25 July 2011 at the 5822:10.1056/NEJMoa052933 5169:Ross, J. S. (2009). 4825:10.1056/NEJMoa052122 4493:26 June 2011 at the 4365:Updated: 8 June 2019 3551:23 February 2013 at 3540:23 February 2013 at 2970:polymorphic variants 2714:, particularly with 2498:immunohistochemistry 2305:Immunohistochemistry 2218:High expression of: 2175:High expression of: 2164:ERBB2/HER2-amplified 2020:aromatase inhibitors 1970:immunohistochemistry 1591:immunohistochemistry 1561:), the collar area ( 1559:axillary lymph nodes 1165:Nuclear pleomorphism 1113:nuclear pleomorphism 891:Peripheral papilloma 826:Non-Hodgkin lymphoma 738:Granular cell tumour 6825:10.1677/erc.1.01222 6774:10.1038/nature07483 6765:2008Natur.456..663H 6735:on 20 February 2009 6629:7 July 2011 at the 6561:2010PNAS..107.5136L 6263:5 June 2011 at the 6244:5 June 2011 at the 5387:2000Natur.406..747P 4167:8 June 2011 at the 3966:Anticancer Research 3932:10.1038/bjc.1957.43 3710:8 July 2011 at the 3319:1 July 2010 at the 3101:immunohistochemical 2989:inhibitors such as 2371:CCDN1 amplification 2293:Medullary carcinoma 2228:Low expression of: 2152: 2000:targeted treatments 1692: 1535:T4c: Both 4a and 4b 1298: 1040:Periductal stromal 1001:Adenomyoepithelioma 980:Pleomorphic adenoma 942:Adenomyoepithelial 821:Malignant lymphoma 668:Sebaceous carcinoma 647:Oncocytic carcinoma 642:Secretory carcinoma 68:confounding effects 7462:Precursor lesions 7453:Male breast cancer 6656:10.2217/pgs.10.112 6116:Annals of Oncology 6046:10.1002/cncr.25269 5653:Nat Rev Clin Oncol 5034:Molecular Oncology 4899:. Cancer Network. 3671:Evans, A. (2004). 2668:Level III evidence 2650:Level III evidence 2598:Level III evidence 2556:(TNBC) basal-like 2523: 2429:DNA classification 2232:HER2-related genes 2192:HER2-related genes 2150: 2128:Normal breast-like 1690: 1516:T2: 2 to 5 cm 1509:T1c: 1.0 to 2.0 cm 1506:T1b: 0.5 to 1.0 cm 1503:T1a: 0.1 to 0.5 cm 1292: 1281:assesses how many 1275: 1140: 894:Atypical papilloma 838:Lobular neoplasia 834:Precursor lesions 803:Male breast cancer 700:Hemangiopericytoma 577:with spindle cell 525:oat cell carcinoma 488:mucinous carcinoma 480:Cystadenocarcinoma 403:Invasive carcinoma 382:WHO classification 333: 322: 178:TNM classification 159:invasive carcinoma 102:Schemes or aspects 86:findings, is that 39:of the tumor, the 7521: 7520: 7481: 7480: 6984:(11): 1070–1076. 6938:(12): 2716–2725. 6759:(7222): 663–666. 6650:(10): 1367–1375. 6555:(11): 5136–5141. 6463:(16): 2630–2637. 6413:(15): 6268–6276. 6365:(20): 3366–3379. 6080:(10): 1671–1676. 6039:(22): 5161–5167. 5998:(29): 7265–7277. 5859:(33): 5287–5312. 5481:10.1159/000258489 5438:10.2325/jbcs.13.2 5381:(6797): 747–752. 4818:(16): 1673–1684. 4664:(17): 3244–3248. 4628:(25): 1604–1608. 4461:on 6 January 2011 4026:Stanford Medicine 3996:Stanford Medicine 3866:(23): 8534–8540. 3790:: 154–161. 2002. 3733:978-92-832-2412-9 3626:Breast Cancer Res 3421:978-1-4377-2182-9 3269:Breast Cancer Res 3241:978-0-387-74037-9 3055:interaction with 2801:complete response 2686:. Although these 2625:Level II evidence 2594:Level II evidence 2500:with response to 2426: 2425: 2417:MYC amplification 2399:signaling pathway 2381:TP53 inactivation 2250:Tubular carcinoma 2093:following section 2053:Molecular subtype 2046:Androgen receptor 1993:following section 1913:"stage migration" 1897: 1896: 1768:Previous editions 1758:estrogen receptor 1745: 1744: 1587:routine histology 1471:Tumor – The 1467:Primary Tumor (T) 1459:(UICC) recommend 1431:estrogen receptor 1386: 1385: 1295:high-power fields 1092: 1091: 453:Tubular carcinoma 240:estrogen receptor 211:metastatic cancer 154:Carcinoma in situ 33:histopathological 16:(Redirected from 7583: 7556:Breast neoplasia 7538: 7537: 7536: 7529: 7410:Fibroepithelials 7338: 7290:Self-examination 7232: 7225: 7218: 7209: 7202: 7201: 7191: 7181: 7157: 7151: 7150: 7140: 7108: 7102: 7101: 7091: 7081: 7057: 7051: 7050: 7040: 7008: 7002: 7001: 6972: 6966: 6965: 6947: 6923: 6917: 6916: 6887: 6881: 6880: 6844: 6838: 6837: 6827: 6803: 6797: 6796: 6786: 6776: 6744: 6742: 6740: 6725: 6719: 6718: 6708: 6698: 6674: 6668: 6667: 6644:Pharmacogenomics 6639: 6633: 6619: 6613: 6599: 6593: 6592: 6582: 6572: 6540: 6534: 6533: 6523: 6513: 6498:Molecular Cancer 6489: 6483: 6482: 6472: 6448: 6442: 6440: 6430: 6398: 6392: 6389: 6383: 6382: 6354: 6348: 6343: 6337: 6336: 6326: 6316: 6292: 6286: 6273: 6267: 6254: 6248: 6235: 6229: 6216: 6210: 6197: 6188: 6175: 6162: 6148: 6142: 6141: 6131: 6106: 6100: 6099: 6089: 6065: 6059: 6058: 6048: 6024: 6018: 6017: 6007: 5983: 5977: 5976: 5974: 5972: 5967:on 26 March 2012 5966: 5960:. 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7362:Comedocarcinoma 7329: 7301: 7241: 7236: 7206: 7205: 7172:(41): 193–196. 7159: 7158: 7154: 7110: 7109: 7105: 7079:10.1186/bcr2464 7059: 7058: 7054: 7010: 7009: 7005: 6978:Lancet Oncology 6974: 6973: 6969: 6925: 6924: 6920: 6889: 6888: 6884: 6846: 6845: 6841: 6805: 6804: 6800: 6746: 6745: 6738: 6736: 6727: 6726: 6722: 6696:10.1186/bcr2612 6676: 6675: 6671: 6641: 6640: 6636: 6631:Wayback Machine 6620: 6616: 6611:Wayback Machine 6600: 6596: 6542: 6541: 6537: 6491: 6490: 6486: 6450: 6449: 6445: 6407:Cancer Research 6400: 6399: 6395: 6390: 6386: 6356: 6355: 6351: 6344: 6340: 6294: 6293: 6289: 6284:Wayback Machine 6274: 6270: 6265:Wayback Machine 6255: 6251: 6246:Wayback Machine 6236: 6232: 6227:Wayback Machine 6217: 6213: 6208:Wayback Machine 6198: 6191: 6186:Wayback Machine 6176: 6165: 6160:Wayback Machine 6149: 6145: 6108: 6107: 6103: 6067: 6066: 6062: 6026: 6025: 6021: 5985: 5984: 5980: 5970: 5968: 5964: 5953: 5949: 5948: 5944: 5914: 5913: 5909: 5904:Wayback Machine 5894: 5890: 5846: 5845: 5838: 5802: 5801: 5794: 5754: 5753: 5744: 5700: 5699: 5688: 5650: 5649: 5645: 5601: 5600: 5596: 5560: 5559: 5555: 5529:10.1186/bcr2596 5509: 5508: 5504: 5466: 5465: 5461: 5423: 5422: 5418: 5368: 5367: 5363: 5317: 5316: 5312: 5268: 5267: 5263: 5217: 5216: 5212: 5168: 5167: 5160: 5124: 5123: 5114: 5076: 5075: 5071: 5027: 5026: 5017: 4973: 4972: 4968: 4924: 4923: 4916: 4906: 4904: 4895: 4894: 4890: 4854: 4853: 4849: 4805: 4804: 4800: 4790: 4788: 4754: 4753: 4744: 4734: 4732: 4728: 4721: 4717: 4716: 4685: 4654: 4653: 4649: 4619: 4618: 4614: 4609:Wayback Machine 4599: 4595: 4590:Wayback Machine 4580: 4576: 4571:Wayback Machine 4561: 4557: 4552:Wayback Machine 4542: 4538: 4533:Wayback Machine 4523: 4519: 4514:Wayback Machine 4504: 4500: 4495:Wayback Machine 4485: 4474: 4464: 4462: 4453: 4451: 4438: 4421: 4378: 4376: 4369: 4358: 4356: 4342: 4341: 4330: 4290: 4289: 4285: 4255: 4254: 4250: 4245:Wayback Machine 4226: 4216: 4209: 4207: 4188:"Breast Cancer" 4185: 4183: 4174: 4169:Wayback Machine 4159: 4148: 4143:Wayback Machine 4133: 4126: 4116: 4114: 4099: 4098: 4094: 4050: 4049: 4045: 4035: 4033: 4020: 4019: 4015: 4005: 4003: 3990: 3989: 3985: 3962: 3961: 3957: 3913: 3912: 3908: 3894: 3893: 3889: 3860:Cancer Research 3850: 3849: 3845: 3834: 3832: 3816: 3815: 3811: 3782:"Republished". 3781: 3746: 3745: 3741: 3734: 3722: 3721: 3717: 3712:Wayback Machine 3683:(Suppl 1): 23. 3670: 3669: 3665: 3619: 3615: 3611: 3601: 3599: 3590: 3556: 3555:(in situ) from 3544:(invasive) and 3532: 3525: 3486: 3484: 3443: 3441: 3437: 3422: 3409: 3406:Wayback Machine 3397: 3386: 3378: 3374: 3362: 3354: 3352: 3335: 3334: 3327: 3321:Wayback Machine 3312: 3308: 3262: 3261: 3257: 3242: 3215: 3214: 3210: 3205: 3200: 3199: 3187: 3185: 3170: 3168: 3147: 3134: 3129: 3117: 3097: 3070: 3068:Computer models 3065: 2997:DNA methylation 2975:PARP inhibitors 2939: 2890:clinical trials 2857: 2851: 2818:(ASCO) and the 2732: 2684:receptor status 2638:(ASCO) and the 2526:DNA microarrays 2515: 2510: 2508:DNA microarrays 2487: 2436: 2431: 2384:Rb inactivation 2357:Gene mutations 2089:DNA microarrays 2055: 1958: 1956:Receptor status 1794: 1792: 1770: 1750: 1700: 1668: 1651: 1609:micrometastasis 1551: 1492:Paget's disease 1469: 1455:(AJCC) and the 1418: 1391: 1267: 1260: 1257: 1248: 1245: 1236: 1233: 1224: 1221: 1167: 1132: 1100: 1093: 1081:Paget's disease 1070:Paget's disease 994:Myoepitheliosis 963:Tubular adenoma 936:Microglandular 783: 638:-rich carcinoma 430:choriocarcinoma 428:Carcinoma with 421:Carcinoma with 384: 374:5-year survival 359:5-year survival 351:breast biopsies 314: 252:triple negative 133:receptor status 109: 104: 23: 22: 15: 12: 11: 5: 7589: 7587: 7579: 7578: 7573: 7568: 7566:Cancer staging 7563: 7558: 7548: 7547: 7543: 7542: 7519: 7518: 7516: 7515: 7510: 7505: 7500: 7495: 7489: 7487: 7483: 7482: 7479: 7478: 7476: 7475: 7473:Nipple adenoma 7470: 7469: 7468: 7460: 7455: 7450: 7445: 7439: 7437: 7433: 7432: 7430: 7429: 7424: 7418: 7416: 7406: 7405: 7403: 7402: 7397: 7392: 7386: 7384: 7378: 7377: 7375: 7374: 7369: 7364: 7359: 7358: 7357: 7346: 7344: 7335: 7331: 7330: 7328: 7327: 7322: 7317: 7311: 7309: 7303: 7302: 7300: 7299: 7294: 7293: 7292: 7282: 7281: 7280: 7275: 7270: 7260: 7258:Classification 7255: 7249: 7247: 7243: 7242: 7237: 7235: 7234: 7227: 7220: 7212: 7204: 7203: 7152: 7103: 7052: 7023:(7): 1074–84. 7003: 6967: 6918: 6899:(4): 980–991. 6882: 6839: 6818:(4): 1135–45. 6798: 6720: 6669: 6634: 6614: 6594: 6535: 6484: 6443: 6393: 6384: 6349: 6338: 6307:(4): 666–671. 6287: 6268: 6249: 6230: 6211: 6189: 6163: 6143: 6122:(3): 625–631. 6101: 6060: 6019: 5978: 5942: 5907: 5888: 5836: 5815:(6): 560–569. 5792: 5757:Van't Veer, L. 5742: 5713:(5): 477–493. 5707:The Oncologist 5686: 5643: 5594: 5573:(10): 1625–7. 5553: 5502: 5459: 5416: 5361: 5310: 5281:(2): 523–535. 5261: 5210: 5181:(4): 204–215. 5158: 5131:The Oncologist 5112: 5069: 5015: 4966: 4914: 4888: 4847: 4798: 4767:(8): 790–800. 4742: 4683: 4647: 4612: 4593: 4574: 4555: 4536: 4517: 4498: 4472: 4436: 4367: 4328: 4283: 4248: 4228:|website= 4194:. StatPearls. 4192:Cancer, Breast 4172: 4146: 4124: 4092: 4063:(4): 839–845. 4043: 4013: 3983: 3955: 3906: 3903:(19): 403–410. 3897:Histopathology 3887: 3843: 3817:Oudai Hassan. 3809: 3784:Histopathology 3749:Histopathology 3739: 3732: 3715: 3690:10.1186/bcr842 3663: 3639:10.1186/bcr767 3632:(3): R149–56. 3609: 3523: 3456:(41): 139–41. 3435: 3420: 3384: 3372: 3325: 3306: 3282:10.1186/bcr608 3255: 3240: 3207: 3206: 3204: 3201: 3198: 3197: 3195: 3194: 3165: 3162: 3159: 3156: 3131: 3130: 3128: 3125: 3116: 3113: 3096: 3093: 3069: 3066: 3064: 3061: 3001:epigenetically 2938: 2935: 2933:gene profile. 2869:breast cancers 2853:Main article: 2850: 2847: 2834:elements when 2832:classification 2797:classification 2745:(ER) positive 2731: 2728: 2672: 2671: 2664: 2643: 2590:breast cancers 2576:tests analyze 2574:DNA microarray 2536:have included 2514: 2511: 2509: 2506: 2486: 2483: 2443:classification 2435: 2432: 2430: 2427: 2424: 2423: 2422: 2421: 2418: 2415: 2412: 2409: 2404: 2403: 2402: 2393: 2392: 2391: 2388: 2385: 2382: 2374: 2373: 2372: 2369: 2366: 2363: 2358: 2354: 2353: 2352: 2351: 2346: 2345: 2344: 2341: 2336: 2335: 2334: 2331: 2328: 2323: 2322: 2321: 2318: 2315: 2312: 2307: 2301: 2300: 2299: 2298: 2295: 2290: 2287: 2282: 2281: 2280: 2277: 2272: 2271: 2270: 2267: 2264: 2259: 2258: 2257: 2254: 2251: 2246: 2239: 2238: 2237: 2236: 2233: 2226: 2225: 2222: 2216: 2215: 2214: 2211: 2206: 2205: 2204: 2201: 2194: 2193: 2190: 2184: 2183: 2182: 2179: 2173: 2169: 2168: 2165: 2162: 2159: 2156: 2148: 2147: 2129: 2126: 2120: 2114: 2111: 2108: 2054: 2051: 1966:breast cancers 1957: 1954: 1895: 1894: 1891: 1888: 1885: 1881: 1880: 1877: 1874: 1871: 1867: 1866: 1863: 1860: 1857: 1853: 1852: 1849: 1846: 1843: 1839: 1838: 1835: 1832: 1829: 1825: 1824: 1821: 1818: 1815: 1811: 1810: 1807: 1804: 1801: 1797: 1796: 1791:Breast cancer 1789: 1786: 1783: 1769: 1766: 1749: 1746: 1743: 1742: 1739: 1735: 1734: 1731: 1727: 1726: 1723: 1719: 1718: 1715: 1711: 1710: 1707: 1703: 1702: 1697: 1688: 1687: 1684: 1681: 1678: 1675: 1667: 1664: 1663: 1662: 1659: 1655: 1650: 1647: 1646: 1645: 1644: 1643: 1640: 1637: 1631: 1630: 1627: 1623: 1622: 1621: 1620: 1613: 1612: 1604: 1603: 1602: 1601: 1594: 1579: 1578: 1550: 1547: 1546: 1545: 1544: 1543: 1536: 1533: 1530: 1524: 1523: 1520: 1517: 1513: 1512: 1511: 1510: 1507: 1504: 1498: 1497: 1494: 1480: 1468: 1465: 1417: 1414: 1409: 1408: 1405: 1402: 1390: 1387: 1384: 1383: 1380: 1377: 1374: 1371: 1368: 1364: 1363: 1360: 1357: 1354: 1351: 1348: 1344: 1343: 1340: 1337: 1334: 1331: 1328: 1324: 1323: 1320: 1317: 1314: 1311: 1307: 1306: 1303: 1266: 1263: 1262: 1261: 1258: 1251: 1249: 1246: 1239: 1237: 1234: 1227: 1225: 1222: 1215: 1212: 1211: 1208: 1205: 1166: 1163: 1162: 1161: 1158: 1155: 1131: 1128: 1099: 1096: 1090: 1089: 1085: 1084: 1074: 1073: 1067: 1061: 1059:Nipple adenoma 1052: 1051: 1045: 1038: 1037: 1036: 1031: 1026: 1016: 1007: 1006: 1003: 998: 995: 988: 987: 986: 985: 984:Ductal adenoma 982: 977: 971: 965: 955: 948: 947: 946: 940: 934: 928: 920: 904: 903: 902: 901: 898: 895: 892: 889: 878: 875: 874: 873: 868: 863: 858: 855: 846: 845: 844: 829: 828: 819: 818: 817: 816: 811: 796: 785: 781: 780: 778:Leiomyosarcoma 775: 770: 765: 760: 755: 750: 745: 740: 735: 734: 733: 723: 718: 712: 707: 702: 697: 692: 679: 678: 675: 670: 665: 659: 654: 649: 644: 639: 633: 632: 631: 628: 625: 624:Carcinosarcoma 622: 619: 610: 609: 608: 607: 593: 592: 591: 586: 581: 575:Adenocarcinoma 572: 551: 548: 543: 540: 535: 534: 533: 527: 521: 514: 513:of the breast) 507:neuroendocrine 500:Neuroendocrine 497: 496: 495: 490: 477: 466: 461: 455: 446: 445: 440: 439: 438: 437: 436: 433: 426: 419: 413: 408: 392: 383: 380: 379: 378: 362: 313: 312:Histopathology 310: 309: 308: 307: 306: 299: 292: 285: 275: 263: 220: 219: 218: 207: 204: 174: 166: 108: 105: 103: 100: 24: 14: 13: 10: 9: 6: 4: 3: 2: 7588: 7577: 7574: 7572: 7569: 7567: 7564: 7562: 7561:Breast cancer 7559: 7557: 7554: 7553: 7551: 7541: 7531: 7527: 7514: 7511: 7509: 7506: 7504: 7501: 7499: 7496: 7494: 7491: 7490: 7488: 7484: 7474: 7471: 7467: 7464: 7463: 7461: 7459: 7456: 7454: 7451: 7449: 7446: 7444: 7441: 7440: 7438: 7434: 7428: 7425: 7423: 7420: 7419: 7417: 7415: 7411: 7407: 7401: 7398: 7396: 7393: 7391: 7388: 7387: 7385: 7383: 7379: 7373: 7370: 7368: 7365: 7363: 7360: 7356: 7353: 7352: 7351: 7348: 7347: 7345: 7343: 7339: 7336: 7332: 7326: 7323: 7321: 7318: 7316: 7313: 7312: 7310: 7308: 7304: 7298: 7295: 7291: 7288: 7287: 7286: 7283: 7279: 7278:BRCA mutation 7276: 7274: 7271: 7269: 7266: 7265: 7264: 7261: 7259: 7256: 7254: 7253:Breast cancer 7251: 7250: 7248: 7244: 7240: 7239:Breast cancer 7233: 7228: 7226: 7221: 7219: 7214: 7213: 7210: 7199: 7195: 7190: 7185: 7180: 7175: 7171: 7167: 7163: 7156: 7153: 7148: 7144: 7139: 7134: 7130: 7126: 7123:(5): 668–75. 7122: 7118: 7114: 7107: 7104: 7099: 7095: 7090: 7085: 7080: 7075: 7071: 7067: 7063: 7056: 7053: 7048: 7044: 7039: 7034: 7030: 7026: 7022: 7018: 7017:Br. J. Cancer 7014: 7007: 7004: 6999: 6995: 6991: 6987: 6983: 6979: 6971: 6968: 6963: 6959: 6955: 6951: 6946: 6941: 6937: 6933: 6929: 6922: 6919: 6914: 6910: 6906: 6902: 6898: 6894: 6886: 6883: 6878: 6874: 6870: 6866: 6862: 6858: 6855:(6): 665–74. 6854: 6850: 6843: 6840: 6835: 6831: 6826: 6821: 6817: 6813: 6809: 6802: 6799: 6794: 6790: 6785: 6780: 6775: 6770: 6766: 6762: 6758: 6754: 6750: 6734: 6730: 6724: 6721: 6716: 6712: 6707: 6702: 6697: 6692: 6688: 6684: 6680: 6673: 6670: 6665: 6661: 6657: 6653: 6649: 6645: 6638: 6635: 6632: 6628: 6625: 6618: 6615: 6612: 6608: 6605: 6598: 6595: 6590: 6586: 6581: 6576: 6571: 6566: 6562: 6558: 6554: 6550: 6546: 6539: 6536: 6531: 6527: 6522: 6517: 6512: 6507: 6503: 6499: 6495: 6488: 6485: 6480: 6476: 6471: 6466: 6462: 6458: 6454: 6447: 6444: 6438: 6434: 6429: 6424: 6420: 6416: 6412: 6408: 6404: 6397: 6394: 6388: 6385: 6380: 6376: 6372: 6368: 6364: 6360: 6353: 6350: 6347: 6342: 6339: 6334: 6330: 6325: 6320: 6315: 6310: 6306: 6302: 6298: 6291: 6288: 6285: 6281: 6278: 6272: 6269: 6266: 6262: 6259: 6253: 6250: 6247: 6243: 6240: 6234: 6231: 6228: 6224: 6221: 6215: 6212: 6209: 6205: 6202: 6196: 6194: 6190: 6187: 6183: 6180: 6174: 6172: 6170: 6168: 6164: 6161: 6157: 6154: 6147: 6144: 6139: 6135: 6130: 6125: 6121: 6117: 6113: 6105: 6102: 6097: 6093: 6088: 6083: 6079: 6075: 6071: 6064: 6061: 6056: 6052: 6047: 6042: 6038: 6034: 6030: 6023: 6020: 6015: 6011: 6006: 6001: 5997: 5993: 5989: 5982: 5979: 5963: 5959: 5952: 5946: 5943: 5938: 5934: 5930: 5926: 5922: 5918: 5911: 5908: 5905: 5901: 5898: 5892: 5889: 5884: 5880: 5875: 5870: 5866: 5862: 5858: 5854: 5850: 5843: 5841: 5837: 5832: 5828: 5823: 5818: 5814: 5810: 5806: 5799: 5797: 5793: 5788: 5784: 5779: 5774: 5771:: S141–S145. 5770: 5766: 5762: 5758: 5751: 5749: 5747: 5743: 5738: 5734: 5730: 5726: 5721: 5716: 5712: 5708: 5704: 5697: 5695: 5693: 5691: 5687: 5682: 5678: 5674: 5670: 5666: 5662: 5659:(11): 615–6. 5658: 5654: 5647: 5644: 5639: 5635: 5630: 5625: 5621: 5617: 5614:(5): 567–73. 5613: 5609: 5605: 5598: 5595: 5590: 5586: 5581: 5576: 5572: 5568: 5564: 5557: 5554: 5549: 5545: 5540: 5535: 5530: 5525: 5521: 5517: 5513: 5506: 5503: 5498: 5494: 5490: 5486: 5482: 5478: 5474: 5470: 5463: 5460: 5455: 5451: 5447: 5443: 5439: 5435: 5431: 5427: 5426:Breast Cancer 5420: 5417: 5412: 5408: 5404: 5400: 5396: 5392: 5388: 5384: 5380: 5376: 5372: 5365: 5362: 5357: 5353: 5349: 5345: 5341: 5337: 5333: 5329: 5325: 5321: 5314: 5311: 5306: 5302: 5297: 5292: 5288: 5284: 5280: 5276: 5272: 5265: 5262: 5257: 5253: 5248: 5243: 5238: 5233: 5229: 5225: 5221: 5214: 5211: 5206: 5202: 5198: 5194: 5189: 5184: 5180: 5176: 5172: 5165: 5163: 5159: 5154: 5150: 5145: 5140: 5136: 5132: 5128: 5121: 5119: 5117: 5113: 5108: 5104: 5100: 5096: 5092: 5088: 5084: 5080: 5073: 5070: 5065: 5061: 5056: 5051: 5047: 5043: 5039: 5035: 5031: 5024: 5022: 5020: 5016: 5011: 5007: 5002: 4997: 4993: 4989: 4985: 4981: 4977: 4970: 4967: 4962: 4958: 4953: 4948: 4944: 4940: 4936: 4932: 4928: 4921: 4919: 4915: 4902: 4898: 4892: 4889: 4884: 4880: 4875: 4870: 4866: 4862: 4858: 4851: 4848: 4843: 4839: 4835: 4831: 4826: 4821: 4817: 4813: 4809: 4802: 4799: 4786: 4782: 4778: 4774: 4770: 4766: 4762: 4758: 4751: 4749: 4747: 4743: 4727: 4720: 4714: 4712: 4710: 4708: 4706: 4704: 4702: 4700: 4698: 4696: 4694: 4692: 4690: 4688: 4684: 4679: 4675: 4671: 4667: 4663: 4659: 4651: 4648: 4643: 4639: 4635: 4631: 4627: 4623: 4616: 4613: 4610: 4606: 4603: 4597: 4594: 4591: 4587: 4584: 4578: 4575: 4572: 4568: 4565: 4559: 4556: 4553: 4549: 4546: 4540: 4537: 4534: 4530: 4527: 4521: 4518: 4515: 4511: 4508: 4502: 4499: 4496: 4492: 4489: 4483: 4481: 4479: 4477: 4473: 4460: 4456: 4449: 4447: 4445: 4443: 4441: 4437: 4432: 4426: 4418: 4414: 4409: 4404: 4399: 4394: 4390: 4386: 4382: 4374: 4372: 4368: 4354: 4350: 4346: 4339: 4337: 4335: 4333: 4329: 4326: 4320: 4316: 4311: 4306: 4303:(5): 857–70. 4302: 4298: 4297:Radiographics 4294: 4287: 4284: 4279: 4275: 4271: 4267: 4263: 4259: 4252: 4249: 4246: 4242: 4239: 4233: 4221: 4205: 4201: 4197: 4193: 4189: 4181: 4179: 4177: 4173: 4170: 4166: 4163: 4157: 4155: 4153: 4151: 4147: 4144: 4140: 4137: 4131: 4129: 4125: 4112: 4108: 4107: 4102: 4096: 4093: 4088: 4084: 4080: 4076: 4071: 4066: 4062: 4058: 4054: 4047: 4044: 4031: 4027: 4023: 4017: 4014: 4001: 3997: 3993: 3987: 3984: 3979: 3975: 3972:(1B): 571–6. 3971: 3967: 3959: 3956: 3951: 3947: 3942: 3937: 3933: 3929: 3926:(3): 359–77. 3925: 3921: 3917: 3910: 3907: 3902: 3898: 3891: 3888: 3883: 3879: 3874: 3869: 3865: 3861: 3857: 3853: 3847: 3844: 3830: 3826: 3825: 3820: 3813: 3810: 3805: 3801: 3797: 3793: 3789: 3785: 3778: 3774: 3770: 3766: 3762: 3758: 3755:(5): 403–10. 3754: 3750: 3743: 3740: 3735: 3729: 3725: 3719: 3716: 3713: 3709: 3706: 3701: 3696: 3691: 3686: 3682: 3678: 3674: 3667: 3664: 3659: 3655: 3650: 3645: 3640: 3635: 3631: 3627: 3623: 3618: 3613: 3610: 3597: 3593: 3586: 3582: 3577: 3572: 3569:(6): 1763–9. 3568: 3564: 3560: 3554: 3553:archive.today 3550: 3547: 3543: 3542:archive.today 3539: 3536: 3530: 3528: 3524: 3519: 3515: 3511: 3507: 3503: 3499: 3495: 3491: 3481: 3477: 3472: 3467: 3463: 3459: 3455: 3451: 3447: 3439: 3436: 3431: 3427: 3423: 3417: 3413: 3407: 3403: 3400: 3395: 3393: 3391: 3389: 3385: 3382: 3376: 3373: 3369: 3368:public domain 3350: 3346: 3344: 3338: 3332: 3330: 3326: 3322: 3318: 3315: 3310: 3307: 3302: 3298: 3293: 3288: 3283: 3278: 3274: 3270: 3266: 3259: 3256: 3251: 3247: 3243: 3237: 3233: 3229: 3225: 3220: 3212: 3209: 3202: 3183: 3179: 3178: 3173: 3166: 3163: 3160: 3157: 3154: 3153: 3151: 3145: 3143: 3141: 3139: 3137: 3133: 3126: 3124: 3122: 3114: 3112: 3110: 3106: 3102: 3094: 3092: 3090: 3087: 3083: 3078: 3075: 3067: 3062: 3060: 3058: 3054: 3050: 3046: 3042: 3038: 3034: 3030: 3026: 3023: 3020: 3015: 3013: 3009: 3004: 3002: 2999:patterns can 2998: 2994: 2992: 2988: 2984: 2983:6-Thioguanine 2980: 2976: 2971: 2968: 2964: 2958: 2956: 2952: 2948: 2944: 2936: 2934: 2932: 2928: 2927:breast cancer 2923: 2921: 2920:negative (N0) 2918: 2914: 2911: 2907: 2903: 2899: 2895: 2891: 2888:A summary of 2886: 2884: 2880: 2877: 2873: 2870: 2866: 2862: 2856: 2848: 2846: 2844: 2840: 2837: 2833: 2829: 2825: 2821: 2817: 2812: 2809: 2804: 2802: 2798: 2794: 2790: 2786: 2782: 2779: 2775: 2770: 2768: 2764: 2760: 2756: 2752: 2748: 2744: 2741: 2737: 2729: 2727: 2725: 2721: 2717: 2713: 2712:controversial 2707: 2705: 2701: 2698:into similar 2697: 2693: 2689: 2685: 2681: 2677: 2669: 2665: 2662: 2658: 2655: 2651: 2647: 2644: 2641: 2637: 2633: 2630: 2626: 2622: 2619: 2618: 2617: 2614: 2611: 2607: 2603: 2599: 2595: 2591: 2587: 2583: 2579: 2575: 2570: 2568: 2564: 2559: 2555: 2550: 2549:proliferation 2546: 2542: 2539: 2535: 2531: 2527: 2519: 2512: 2507: 2505: 2503: 2499: 2495: 2491: 2484: 2482: 2480: 2476: 2472: 2468: 2464: 2460: 2456: 2452: 2448: 2444: 2441: 2433: 2428: 2419: 2416: 2413: 2410: 2407: 2406: 2405: 2400: 2396: 2395: 2394: 2389: 2386: 2383: 2380: 2379: 2378: 2375: 2370: 2367: 2364: 2361: 2360: 2359: 2356: 2355: 2349: 2348: 2347: 2342: 2340:HER2 positive 2339: 2338: 2337: 2332: 2329: 2326: 2325: 2324: 2319: 2317:HER2 negative 2316: 2313: 2310: 2309: 2308: 2306: 2303: 2302: 2296: 2294: 2291: 2288: 2285: 2284: 2283: 2278: 2275: 2274: 2273: 2268: 2265: 2262: 2261: 2260: 2255: 2252: 2249: 2248: 2247: 2244: 2241: 2240: 2234: 2231: 2230: 2229: 2223: 2220: 2219: 2217: 2212: 2209: 2208: 2207: 2202: 2199: 2198: 2197: 2191: 2188: 2187: 2185: 2180: 2177: 2176: 2174: 2171: 2170: 2166: 2163: 2160: 2157: 2155: 2154: 2145: 2141: 2137: 2133: 2130: 2127: 2125: 2121: 2119: 2115: 2112: 2109: 2106: 2103:(TNBC). Most 2102: 2098: 2097: 2096: 2094: 2090: 2086: 2082: 2081:breast cancer 2078: 2075: 2071: 2067: 2063: 2059: 2052: 2050: 2047: 2043: 2041: 2037: 2033: 2029: 2025: 2021: 2017: 2013: 2009: 2005: 2001: 1996: 1994: 1990: 1986: 1982: 1978: 1975: 1971: 1967: 1963: 1955: 1953: 1951: 1946: 1944: 1940: 1935: 1932: 1927: 1924: 1920: 1916: 1914: 1908: 1906: 1902: 1892: 1889: 1886: 1883: 1882: 1878: 1875: 1872: 1869: 1868: 1864: 1861: 1858: 1855: 1854: 1850: 1847: 1844: 1841: 1840: 1836: 1833: 1830: 1827: 1826: 1822: 1819: 1816: 1813: 1812: 1808: 1805: 1802: 1799: 1798: 1790: 1787: 1784: 1781: 1780: 1777: 1774: 1767: 1765: 1763: 1759: 1755: 1747: 1740: 1737: 1736: 1732: 1729: 1728: 1724: 1721: 1720: 1716: 1713: 1712: 1708: 1705: 1704: 1698: 1695: 1694: 1685: 1682: 1679: 1677:Stage I: T1N0 1676: 1673: 1672: 1671: 1666:Overall stage 1665: 1660: 1656: 1653: 1652: 1648: 1641: 1638: 1635: 1634: 1633: 1632: 1628: 1625: 1624: 1617: 1616: 1615: 1614: 1610: 1606: 1605: 1599: 1595: 1592: 1588: 1583: 1582: 1581: 1580: 1576: 1575: 1574: 1572: 1568: 1564: 1560: 1556: 1548: 1541: 1537: 1534: 1531: 1528: 1527: 1526: 1525: 1521: 1518: 1515: 1514: 1508: 1505: 1502: 1501: 1500: 1499: 1495: 1493: 1489: 1485: 1481: 1478: 1477: 1476: 1474: 1466: 1464: 1462: 1458: 1454: 1449: 1445: 1442: 1440: 1436: 1432: 1427: 1422: 1415: 1413: 1406: 1403: 1400: 1396: 1395: 1394: 1389:Overall grade 1388: 1381: 1378: 1375: 1372: 1369: 1366: 1365: 1361: 1358: 1355: 1352: 1349: 1346: 1345: 1341: 1338: 1335: 1332: 1329: 1326: 1325: 1322:0.31 mm 1321: 1318: 1315: 1312: 1310:0.096 mm 1309: 1308: 1300: 1296: 1290: 1287: 1284: 1280: 1271: 1265:Mitotic count 1264: 1255: 1250: 1243: 1238: 1231: 1226: 1219: 1214: 1209: 1206: 1203: 1202: 1201: 1199: 1195: 1190: 1188: 1184: 1180: 1176: 1172: 1164: 1159: 1156: 1153: 1152: 1151: 1148: 1145: 1136: 1129: 1127: 1124: 1122: 1118: 1117:mitotic count 1114: 1110: 1104: 1097: 1095: 1088: 1083:of the nipple 1082: 1079: 1078: 1077: 1072:of the nipple 1071: 1068: 1065: 1064:Syringomatous 1062: 1060: 1057: 1056: 1055: 1050: 1046: 1043: 1039: 1035: 1032: 1030: 1027: 1025: 1022: 1021: 1020: 1017: 1015: 1012: 1011: 1010: 1004: 1002: 999: 996: 993: 992: 991: 983: 981: 978: 975: 972: 969: 966: 964: 961: 960: 959: 956: 953: 949: 945: 941: 939: 935: 933: 929: 927: 924: 921: 918: 915: 914: 912: 909: 908: 907: 899: 896: 893: 890: 888: 884: 883: 882: 879: 876: 872: 869: 867: 864: 862: 859: 856: 854: 851:Usual ductal 850: 849: 847: 843: 840: 839: 837: 836: 835: 832: 827: 824: 823: 822: 815: 812: 810: 807: 806: 804: 800: 797: 794: 791: 790: 789: 786: 784: 779: 776: 774: 771: 769: 766: 764: 761: 759: 756: 754: 751: 749: 746: 744: 741: 739: 736: 732: 729: 728: 727: 724: 722: 719: 716: 713: 711: 708: 706: 703: 701: 698: 696: 693: 691: 688: 687: 686: 684: 676: 674: 671: 669: 666: 663: 660: 658: 655: 653: 650: 648: 645: 643: 640: 637: 634: 629: 626: 623: 620: 617: 616: 615: 614: 613: 605: 602: 598: 594: 590: 587: 585: 582: 580: 576: 573: 571: 568: 567: 565: 562: 558: 557: 555: 552: 549: 547: 544: 541: 539: 536: 532: 528: 526: 523:Small cell / 522: 519: 515: 512: 508: 504: 503: 501: 498: 494: 491: 489: 485: 481: 478: 476: 473: 472: 471: 467: 465: 462: 459: 456: 454: 451: 450: 449: 444: 441: 434: 431: 427: 424: 420: 417: 414: 412: 411: 409: 406: 405: 404: 401: 400: 399: 396: 395: 391: 389: 381: 375: 371: 367: 363: 360: 356: 352: 348: 347: 342: 341: 340: 338: 330: 326: 318: 311: 304: 300: 297: 293: 290: 286: 283: 279: 278: 276: 272: 268: 264: 261: 257: 253: 249: 245: 241: 237: 233: 229: 225: 221: 216: 212: 209:Stage 4 is a 208: 205: 202: 198: 194: 193: 191: 186: 185:breast cancer 183: 179: 175: 171: 167: 164: 160: 156: 155: 150: 146: 142: 141: 140: 138: 134: 130: 127: 123: 119: 115: 114:physical exam 106: 101: 99: 97: 93: 89: 85: 84:physical exam 81: 76: 73: 69: 65: 61: 56: 52: 50: 46: 42: 38: 34: 30: 29:breast cancer 19: 7422:Fibroadenoma 7263:Risk factors 7257: 7169: 7165: 7155: 7120: 7116: 7106: 7069: 7065: 7055: 7020: 7016: 7006: 6981: 6977: 6970: 6935: 6931: 6921: 6896: 6892: 6885: 6852: 6848: 6842: 6815: 6811: 6801: 6756: 6752: 6737:. 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Retrieved 3175: 3118: 3098: 3079: 3071: 3016: 3010:co-receptor 3005: 2995: 2959: 2940: 2924: 2887: 2858: 2828:chemotherapy 2813: 2805: 2789:radiotherapy 2781:chemotherapy 2771: 2763:chemotherapy 2733: 2708: 2673: 2615: 2571: 2524: 2488: 2438:Traditional 2437: 2376: 2227: 2195: 2118:bicalutamide 2056: 2044: 1997: 1959: 1947: 1936: 1928: 1925: 1921: 1917: 1909: 1898: 1809:AJCC or NCI 1782:AJCC edition 1775: 1771: 1751: 1674:Stage 0: Tis 1669: 1552: 1470: 1450: 1446: 1443: 1419: 1410: 1392: 1319:0.27 mm 1316:0.16 mm 1313:0.12 mm 1302:Area per HPF 1288: 1276: 1191: 1168: 1149: 1141: 1125: 1105: 1101: 1094: 1086: 1075: 1053: 1014:Fibroadenoma 1008: 989: 905: 833: 830: 820: 793:Gynecomastia 787: 782: 768:Osteosarcoma 753:Angiosarcoma 743:Neurofibroma 717:(aggressive) 715:Fibromatosis 695:Angiomatosis 680: 611: 447: 397: 385: 344: 334: 298:assessments. 158: 152: 110: 80:histological 77: 57: 53: 26: 7498:Pink ribbon 6739:14 November 5971:12 December 5958:ipsogen.com 5608:Clin Trials 5040:(1): 5–23. 4385:Front Oncol 4036:31 December 4006:31 December 3852:Al-Kuraya K 3022:polymorphic 2947:doxorubicin 2836:stratifying 2785:neoadjuvant 2730:Oncotype DX 2621:Oncotype DX 2606:prospective 2502:trastuzumab 2167:Basal-like 2144:lymphocytes 2049:treatment. 2032:trastuzumab 2008:trastuzumab 1461:TNM staging 1187:chromosomes 1179:pleomorphic 1175:cell nuclei 1044:, low-grade 930:Blunt duct 853:hyperplasia 758:Liposarcoma 731:Angiolipoma 604:metaplastic 601:mesenchymal 566:carcinomas 564:metaplastic 556:carcinomas 554:Metaplastic 529:Large cell 509:carcinoma ( 425:giant cells 416:Pleomorphic 296:comorbidity 190:lymph nodes 176:Stage. The 145:histologies 137:DNA testing 7550:Categories 7320:Mastectomy 6689:(4): 206. 5765:The Breast 5522:(3): R42. 5432:(1): 2–7. 4391:: 982461. 4377:Data from 3964:systems". 3203:References 3099:Among the 3074:algorithms 3041:biomarkers 2991:everolimus 2931:MammaPrint 2917:lymph node 2865:lymph node 2855:MammaPrint 2774:prognostic 2767:predictive 2759:prognostic 2720:prognostic 2716:lymph node 2704:concordant 2646:MammaPrint 2513:Background 2471:prognostic 2467:predictive 2414:BRCA1 loss 2140:E-cadherin 2138:including 1964:status of 1931:metastatic 1730:Stage III 1555:lymph node 1490:(LCIS) or 1448:obtained. 1192:Note: The 1029:Borderline 952:sclerosing 917:Sclerosing 748:Schwannoma 690:Hemangioma 606:carcinomas 597:epithelial 579:metaplasia 561:epithelial 423:osteoclast 377:follow-up. 343:Carcinoma 303:mastectomy 282:algorithms 274:effective. 246:(PR), and 92:carcinomas 72:prognostic 60:algorithms 58:Treatment 35:type, the 7307:Treatment 7297:Treatment 7285:Screening 7072:(1): R1. 5356:143423297 5340:1072-4109 5137:: 61–70. 5079:Pathology 4465:3 January 4359:21 August 4258:Radiology 4230:ignored ( 4220:cite book 4210:4 October 4117:2 October 4079:0973-1482 3835:2 October 3804:208083532 3510:0959-8049 3430:489074868 3399:Page 1084 3188:2 October 3148:Area per 3105:prognosis 3037:CYP2C19*2 3029:tamoxifen 2867:negative 2755:prognosis 2663:approval. 2475:TNM stage 2451:prognosis 2401:signature 2320:Low Ki-67 2161:Luminal B 2158:Luminal A 2085:prognoses 2040:prognosis 2024:prognosis 2016:tamoxifen 2004:tamoxifen 1983:(PR) and 1977:receptors 1941:(NCI) or 1785:published 1738:Stage IV 1722:Stage II 1701:survival 1426:prognosis 1399:prognosis 1279:parameter 1171:parameter 1144:parameter 1049:hamartoma 1034:Malignant 968:Lactating 887:papilloma 799:Carcinoma 773:Leiomyoma 518:carcinoid 516:Atypical 511:carcinoid 418:carcinoma 386:The 2012 228:cytoplasm 224:receptors 7540:Medicine 7198:20956828 7147:20664598 7098:20053270 7047:19724274 6998:19801202 6962:27080534 6954:15837986 6913:11181660 6877:39034059 6869:19456271 6834:17158759 6793:19005469 6715:20649975 6664:21047200 6627:Archived 6607:Archived 6589:20194742 6530:21092249 6479:19380449 6437:20631063 6379:20530283 6333:12915875 6280:Archived 6261:Archived 6242:Archived 6223:Archived 6204:Archived 6182:Archived 6156:Archived 6138:21652577 6096:20065191 6055:20665886 6014:16145055 5937:20138540 5900:Archived 5883:17954709 5831:16899776 5787:19914534 5759:(2009). 5737:19435207 5729:18515733 5681:32411967 5673:20981123 5638:20392785 5589:20065178 5548:20576095 5497:21011879 5489:20130425 5469:Oncology 5446:16518056 5403:10963602 5348:31045583 5305:21671017 5256:21633010 5205:37465636 5197:19546609 5153:21278442 5107:39374813 5099:19089743 5064:21147047 5010:21325075 4961:21633166 4901:Archived 4883:17671126 4834:16236738 4785:Archived 4781:19228622 4726:Archived 4678:12947058 4605:Archived 4586:Archived 4567:Archived 4548:Archived 4529:Archived 4510:Archived 4491:Archived 4417:36387150 4353:Archived 4349:medscape 4241:Archived 4204:Archived 4200:29493913 4165:Archived 4139:Archived 4111:Archived 4087:25579516 4030:Archived 4000:Archived 3950:13499785 3882:15574759 3829:Archived 3824:Medscape 3777:17622089 3708:Archived 3658:15084238 3585:19454615 3549:Archived 3538:Archived 3518:28646773 3496:: 6–15. 3480:20956818 3402:Archived 3355:5 August 3349:Archived 3317:Archived 3301:14580242 3250:17993229 3182:Archived 3089:adjuvant 3086:systemic 3053:isoforms 2979:olaparib 2977:such as 2913:receptor 2910:estrogen 2883:fixative 2879:receptor 2876:estrogen 2778:adjuvant 2769:factor. 2751:formalin 2743:receptor 2740:estrogen 2657:receptor 2654:estrogen 2632:receptor 2629:estrogen 2578:clusters 2534:clusters 2490:HER2/neu 2485:HER2/neu 2447:dividing 2411:RB1 loss 2124:HER2/neu 2058:Receptor 2012:adjuvant 2002:such as 1974:estrogen 1962:receptor 1762:HER2/neu 1760:(ER) or 1714:Stage I 1706:Stage 0 1486:(DCIS), 1439:HER2/neu 1047:Mammary 974:Apocrine 958:Adenomas 944:adenosis 938:adenosis 932:adenosis 926:adenosis 923:Apocrine 919:adenosis 911:Adenosis 885:Central 814:Invasive 795:(benign) 662:Glycogen 502:tumours 484:columnar 432:features 248:HER2/neu 236:hormones 107:Overview 96:inflamed 45:proteins 7414:stromal 7382:Lobular 7268:Alcohol 7246:General 7189:5161065 7138:2938244 7089:2880419 7038:2768087 6784:2920208 6761:Bibcode 6706:2949642 6580:2841938 6557:Bibcode 6521:3002335 6504:: 300. 6428:2913123 6324:2376904 5874:2793754 5629:3913192 5539:2917037 5454:6255927 5411:1280204 5383:Bibcode 5296:3303043 5247:3286979 5055:5528267 5001:3076683 4952:3127435 4842:9534884 4791:16 June 4642:4000199 4408:9659859 4319:2217975 4278:3347753 3978:9568179 3941:2073885 3769:1757079 3700:3300383 3602:15 June 3546:Table 3 3535:Table 6 3471:5161058 3082:cohorts 3025:alleles 2955:taxanes 2951:tubulin 2543:genes, 2538:hormone 2459:S phase 2365:MAPK3K1 2132:Claudin 2006:and or 1421:Staging 1297:(HPFs) 1283:mitotic 1066:adenoma 1042:sarcoma 976:adenoma 970:adenoma 809:In situ 683:sarcoma 346:in situ 232:nucleus 182:staging 170:Grading 168:Grade. 94:by the 7526:Portal 7342:Ductal 7196: 7186: 7145: 7135: 7096: 7086: 7045: 7035: 6996: 6960: 6952: 6911: 6875: 6867: 6832: 6791: 6781: 6753:Nature 6713: 6703: 6662: 6587: 6577: 6528: 6518: 6477: 6435: 6425: 6377: 6331: 6321: 6136: 6094: 6053: 6033:Cancer 6012: 5935: 5881: 5871: 5829: 5785: 5735: 5727: 5679: 5671: 5636: 5626: 5587: 5546: 5536: 5495: 5487: 5452: 5444: 5409: 5401: 5375:Nature 5354: 5346: 5338: 5303: 5293: 5254: 5244: 5203: 5195: 5151: 5105: 5097: 5062: 5052: 5008: 4998: 4959: 4949: 4881: 4840: 4832: 4779: 4735:3 July 4676: 4640: 4415: 4405: 4317: 4276: 4198: 4085: 4077: 3976: 3948: 3938: 3880: 3802: 3775: 3767: 3730: 3697: 3656: 3649:400666 3646: 3583: 3516: 3508: 3478: 3468: 3428: 3418: 3299: 3292:314400 3289: 3248: 3238: 3045:HOXB13 3033:CYP2D6 2824:tumors 2791:, and 2747:tumors 2586:cancer 2558:tumors 2479:cancer 2463:ploidy 2362:PI3KCA 2245:types 1979:(ER), 1699:5-year 1598:RT-PCR 1571:apical 1379:>22 1376:>19 1373:>10 1305:Score 1194:cancer 1115:, and 1087: 1024:Benign 954:lesion 726:Lipoma 595:Mixed 505:Solid 242:(ER), 7486:Other 7436:Other 7334:Types 6958:S2CID 6873:S2CID 5965:(PDF) 5954:(PDF) 5733:S2CID 5677:S2CID 5493:S2CID 5450:S2CID 5407:S2CID 5352:S2CID 5201:S2CID 5103:S2CID 4907:8 May 4838:S2CID 4729:(PDF) 4722:(PDF) 3800:S2CID 3773:S2CID 3345:(FDA) 3341:U.S. 3127:Notes 2967:BRCA2 2963:BRCA1 2906:stage 2808:HER-2 2736:genes 2696:tumor 2692:genes 2680:grade 2582:genes 2530:genes 2368:GATA3 2105:BRCA1 2077:grade 2074:tumor 1890:1978 1887:1977 1876:1984 1873:1983 1862:1989 1859:1988 1848:1993 1845:1992 1834:1998 1831:1997 1820:2003 1817:2002 1806:2010 1803:2009 1717:100% 1709:100% 1696:Stage 1619:well. 1538:T4d: 1482:Tis: 1473:tumor 1416:Stage 1370:>8 1367:>7 1359:12-22 1356:10-19 1277:This 1183:genes 1169:This 1142:This 1098:Grade 801:(See 636:Lipid 559:Pure 520:tumor 486:cell 470:mucin 329:Ducts 129:(TNM) 126:stage 122:grade 49:genes 41:stage 37:grade 7194:PMID 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