MOLECULAR PATHOLOGY OF BREAST-CANCER AND ITS APPLICATION TO CLINICAL MANAGEMENT

Breast cancer is a major cause of morbidity and mortality in women in many parts of the world. Breast carcinomas are heterogenous in their b iological and clinical behaviour and a greater understanding of how th ey develop and progress could lead to more directed forms of screening and therapy. It is important to determine the molecular mechanisms un derlying the natural history of breast cancer. Developments in the tec hniques for molecular analysis have meant that they can now be applied to a large range of clinical material such as cytological preparation s and fixed, embedded material, so increasing the potential for relati ng any molecular alterations to clinical behaviour and response to the rapy. In this review we consider recent developments in three areas of importance to breast cancer: genetic analysis - oncogenes, tumour sup pressor genes, loss of heterozygosity, microsatellite instability, fam ilial breast cancer; steroid receptors, oestrogen regulated proteins, epidermal growth factor receptor, growth factors particularly transfor ming growth factor beta; and cell adhesion, invasion and metastasis - E-cadherin, integrins, proteases. These are discussed in relation to p otential for screening, prognosis and treatment.