The importance of molecular biology to cancer surgery

Over the last two decades there have been striking advances in molecular biology, which now have, and will continue to have, great impact on the diagnosis and treatment of patients with either benign or malignant diseases. The translation of these new findings from the laboratory to the clinic has just begun and promises to revolutionize the care of patients with certain neoplastic diseases. The most significant advances relate to molecular genetics, particularly the identification of inherited germline mutations that can be identified in kindred members by direct DNA testing. The surgical oncologist is in a pivotal position to define prophylactic interventional strategies for patients who are destined to develop certain solid tumor malignancies. The most immediate opportunities will be in the patients with hereditary disorders, such as breast cancer, large bowel cancer, and the endocrine neoplasia syndromes.