Stratification du risque après cancer du sein

Assessing the risk of recurrence after breast cancer surgery is particularly important in order to establish the prognosis of the patients and to propose adequate adjuvant treatments. The clinicopathological parameters defined by the consensus of Saint-Gallen are routinely used for this purpose. Since recently other tools based on gene expression profiling in the tumour are available. They allow more precise prognosis and also assessing the benefit of adjuvant chemotherapy in patients with endocrine-sensitive cancer. HER2 positive and triple-negative breast cancers are also being stratified according to their biology or immune reaction objectified by lymphocytic intra- or peritumoral infiltration. The methods for detection of circulating tumour DNA or tumour cells themselves in the blood or bone marrow are particularly interesting to assess residual disease, but still need to be validated before clinical application.