The thorough evaluation of a breast biopsy is critical to the delivery of high quality breast health care. This includes the full range of microscopic and genetic analyses in order to permit the effective design of individualized treatment strategies. This is particularly important given the rapidly increasing range of targeted therapies that work for tumors with alterations in particular cellular functions or genes.
Depending upon the characteristics of the breast area of concern, the biopsy may be either a fine needle aspirate (FNA) or a core needle biopsy. In either case, it is important that the full range of analyses be performed to provide all the necessary information to permit the design of individualized treatment strategies. With the rapidly expanding range of therapies, including new agents that target specific biological pathways, and with new gene expression profiles that aid our efforts to choose the optimal therapeutic plan for each patient, it becomes imperative that there be careful planning before the biopsy and experience in handling these tissues.
We routinely request our pathologists to tell us not only the type of lesion, tumor or not, but its exact type, its hormone receptor expression pattern, and whether specific biological pathways are abnormal, for example is HER2/neu overexpressed.