[Current standards for the diagnosis of breast carcinoma in routine practice]

Every pathologist in active practice must be aware of and follow, set standards and recommendations for the diagnosis of breast carcinoma in order to ensure that the patient has the preconditions for an adequate therapy, regardless of the particular hospital setting. According to present-day knowledge, the standard obligatory examinations include conventional morphology (staging, typing and grading of the tumour) and the analysis of the steroid hormone receptor status (estrogen and progesterone). The immunohistochemical determination of tumour growth fraction with the Ki-67 antibody is economically justifiable, since it serves as an adjunct for histological/cytological tumour grading, a method that has a poor level of reproducibility. Since the introduction of herceptin immunotherapy, the determination HER-2/neu overexpression has gained a practical role and should now be included as an obligatory component of the diagnostic testing. Additional tumour markers are not components of routine diagnosis and these should be limited to clinical studies as long as their prognostic and therapeutic value have not been proven.