Breast cancer: pathologic and prognostic evaluation

Breast cancer presentation is changing, with more tumors detected at an early stage. This makes choosing the most appropriate tests for evaluation of a particular tumor more difficult. Mammography with biopsy of suspicious areas reveals an increasing incidence of microscopic cancers, with a corresponding reduction in larger palpable cancers. Coincidentally, a number of tests for evaluating these cancers, which may affect treatment, have been developed. These includes immunohistochemical evaluation of estrogen receptor and progesterone receptor status and a number of tests still listed as investigational. This paper reviews the diagnosis, evaluation, and prognosis of breast cancers, and suggests an optimal way for handling these tumors.