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Evidence Based Pathology and Laboratory Medicine pp 61–93Cite as

Prognostication and Prediction in Anatomic Pathology: Carcinoma of the Breast as an Illustrative Model

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Abstract

Despite strong assertions to the contrary, both in the lay press and in medical publications, the current status of new prognostic or predictive medical tests for human malignancies is a chaotic one with dubious cost-effectiveness. A lack of uniformity exists in how those tests are performed and interpreted, and their meaning is often obscured by poorly constructed and administrated clinical trials. In specific reference to breast carcinoma, these have been enumerated earlier in our discussion, including factors such as recognition of “special” histologic variants, accurate measurement of tumor size, BSR grade, mitotic rate, lymph node substage, and the presence of angiolymphatic invasion. As laboratory methods are refined, and as novel, potentially highly effective biological treatments become available and are tailored to specific neoplasms (e.g., imatinib for gastrointestinal stromal tumors and chronic myelogenous leukemia [1, 2], this situation may well change). At the present time, however, pathologists must be systematic and critical in their assessments of new PPMTs, with a strict threshold for acceptance of those methods as “state-of-the-art” procedures.

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    Mark R. Wick (Professor and Associate Director of Surgical Pathology)

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    Mark Wick

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Wick, M.R., Swanson, P.E., Marchevsky, A.M. (2011). Prognostication and Prediction in Anatomic Pathology: Carcinoma of the Breast as an Illustrative Model. In: Marchevsky, A., Wick, M. (eds) Evidence Based Pathology and Laboratory Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1030-1_5

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