New classification of breast tumors and lesions, their hormonal sensitivity a and our possibilities of prevention
Abstract
During the last years five molecular subtypes of breast cancers have been characterized by molecular-genetic profiling (luminal A, B basal like, HER2 positive and normal breast like cancers). It has become apparent that estrogen receptor positive (ER+) and estrogen receptor negative (ER-) breast lesions and cancers are distinct disease with different genomic aberrations.
ER+ cancers are luminal, low-grade lesions, usually with good prognosis, but ER- cancers are aggressive, high-grade lesions with a poor response to therapy and poor outcomes. It has been claimed that mammography screening reduces breast cancer mortality by 30%, but through systematic reviews have estimated only 15% reduction.
Mammographic screening is effective in the group of slowly growing, luminal cancers; however high-grade, rapid growing cancers would escape from screening interval. Some of these cancers are so aggressive that even ""early"" detection is too late, woman dies despite detection by mammography.
In fact, that we can't expect next reduction of breast cancer mortality by mammographic screening, therefore our possibilities with chemoprevention of ER+ and ER+ cancer have been reviewed.