Genomics in breast cancer - therapeutic implications

The introduction of DNA microarray techniques has had dramatic implications on cancer research, allowing researchers to analyze expression of multiple genes in concert and relate the findings to clinical parameters. The main discoveries in breast cancer, as well as in other malignancies, have so far been with respect to two key issues. First, individual tumors arising from the same organ may be grouped into distinct classes based on their gene expression profiles, independent of stage and grade. Second, the biologic relevance of such classification is corroborated by significant prognostic impact. We review how the use of microarray technologies can provide unique possibilities to explore the mechanisms of tumor behavior in vivo that will allow evaluation of prognosis and, potentially, drug resistance. However, in spite of recent advances, we are not yet at a stage where the use of these techniques should be implemented for routine clinical use, whether to define prognostic factors or to predict sensitivity to therapy.