The Role of the Indispensable Surgical Pathologist in Treatment Planning for Breast Cancer

摘要

The diagnosis of breast cancer is devastating news for women of any age and immediately raises a number of pressing questions for the patient: Will the tumor return in the future? Will she survive, and what additional treatments beyond surgery are necessary for the best possible outcome? Women placed in these situations are fearful and confused, and they seek reassurance and information. While reassurance can readily be given, clear information to guide decisions about treatment is more elusive because of the increasing complexity of breast cancer treatment options.The treatment of breast cancer has become increasingly specialized, with rapidly changing therapies and new therapeutic guidelines. These changes have been driven by a number of complex factors, including advances in molecular biology (with the developing capability of clinically relevant molecular subtyping of tumors) and the rapid development of new cancer therapies directed at these molecular subtypes. In an effort to provide state-of-the-art care, provide the most definitive and timely information to patients, and keep up with these rapid advances in diagnosis and treatment, many centers have developed multidisciplinary breast cancer clinics. The physicianswho staff these clinics typically include surgeons, medical oncologists, radiation oncologists, and breast radiologists who have become increasingly specialized in the many facets involved in the diagnosis and treatment of breast cancer. Such specialization has allowed these physicians to become experts in their respective disciplines and to provide state-of-the-art care for their patients. Despite these advances, charting a course through the increasingly complex therapeutic algorithms for an individual patient remains clinically challenging.