Neoplasms of the Breast

Abstract

Overview Breast cancer in women remains a major medical problem with significant public health and societal ramifications, including issues related to screening, risk factors, prevention, diagnosis, treatment, and survival following diagnosis. Major advances have markedly improved the understanding of clinical phenotypes, as well as the biologic pathways that drive tumor growth and resistance. This research has led to dramatic changes in treatment that have contributed to a significant reduction in breast cancer mortality over the last two decades, and is the basis of ongoing clinical research. Molecular profiling has provided insights into the heterogeneity of breast cancer subtypes; combining biology and tumor burden has allowed stratification of both risk and treatment to begin the process of individualizing screening, prevention, and treatment. As new information accumulates, new paradigms of management become the standard of care reflected in international guidelines. Our challenge is to apply new formation and treatment appropriately and effectively, and to understand both response and resistance. Information obtained from molecular, biologic, and pathologic investigations and clinical trials provides the major focus of this chapter.