Klinische relevanz von tumor-invasions- und proliferations-faktoren beim mammakarzinom

Prognostic and predictive factors are the prerequisite for risk-adapted, individualized therapy decisions in primary breast cancer. Established prognostic factors (lymph node status, grading, tumor size, steroid hormone receptor status) do not achieve optimal identification of high-risk patients. Thus, identification of new and better prognostic factors is a clinically relevant task. In particular, in node-negative breast cancer patients, new tumor-biological factors are needed as selection criteria for adjuvant systemic therapy. For this purpose, factors describing a tumor's potential for invasion and metastasis (uPA, PAI-1, cathepsin D) or its proliferative activity (S-phase, Ki-67) have been put forward in the literature. This review focuses on a direct comparison of these two groups of tumor biological factors taking into account our own data as well as published results.