Bioclinical markers in breast cancer: Updates and perspectives

Molecular studies have definitely changed our knowledge of the biology of cancers, and breast cancer's tremendous social impact has stimulated a large mass of research. Classic markers have opened a road, but their usefulness appears limited to prognosis or follow up, while several new markers, both genetic and molecular, are assuming different, yet still controversial, importance: they may play a major role in the surveillance of subjects at risk, in detecting primary or recurrent cancers, and in predicting the need of adjuvant therapy, or the response to therapy. Nevertheless, the mandatory routine markers out of trials are not really modified when compared to the 2007 guidelines, essentially due to a lack of appropriate levels of evidence. For this reason we can only recommend to include as many women as possible in specific trials, in order to reach the evidence level that we need to substantially improve our understanding of cancer and eventually the outcome for women with breast cancer.