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Breast
Histopathologic Diagnoses
Malignant Lesions
Luminal A and B Cancers
Luminal A and B Cancers
Kanchan Phalak, MD; Wei Tse Yang, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Major types of invasive cancer based on gene expression: Estrogen receptor (ER); progesterone receptor (PR); human epidermal growth factor 2 (HER2, product of ERBB2 gene)
              • Intrinsic subtypes: Luminal A; luminal B HER2(+); luminal B HER2(-); nonluminal HER2; basal-like breast cancer (BLBC)
              • Immunohistochemistry (IHC) surrogate for intrinsic subtype by tumor genomics
              • Luminal A invasive cancers
                • High expression of ER and luminal cytokeratins
                • PR expression in ≥ 20% of tumor cells
                • No overexpression of HER2
                • Low Ki-67 proliferation index (~ < 10%)
              • Luminal B [HER2(+)]
                • ER(+); may be PR(+) or PR(-)
                  • Expression of ER and related genes < luminal A
                • Overexpression of HER2 [HER2(+)]
                • Possible overexpression of EGFR
                • Any proliferation index
              • Luminal B [HER2(-)]
                • ER(+) and at least 1of following
                  • Negative or low-level (< 20%) PR(+)
                  • High proliferation index (Ki-67 ≥ 20%)
              • Concordance of IHC with intrinsic subtype only ~ 64% for luminal tumors
                • Oncotype DX [ER(+) T1-2, N0 and selectively N1 tumors] or MammaPrint [ER(+) or (-), T1-3, N0-1 tumors] → recurrence risk with endocrine therapy alone
                • BluePrint, Prosigna (PAM50) can provide intrinsic subtype if needed for chemotherapy decisions
              • Classic HER2(+) (nonluminal): ER/PR(-), HER2(+)
              • Triple-negative breast cancer (TNBC): ER/PR/HER2(-)
              • Basal-like cancer: ER/PR/HER2(-), express cytokeratins
                • Some tumors with low positivity ER on IHC may cluster with basal-like cancers on gene expression

            IMAGING

            • Mammographic Findings

              • Ultrasonographic Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Farshid G et al: Molecular subtypes of screen-detected breast cancer. Breast Cancer Res Treat. 172(1):191-199, 2018
                                        2. Francis PA et al: Tailoring Adjuvant Endocrine Therapy for Premenopausal Breast Cancer. N Engl J Med. 379(2):122-137, 2018
                                        3. Partridge SC et al: Diffusion-weighted MRI Findings Predict Pathologic Response in Neoadjuvant Treatment of Breast Cancer: The ACRIN 6698 Multicenter Trial. Radiology. 180273, 2018
                                        4. Scheel JR et al: MRI, Clinical Examination, and Mammography for Preoperative Assessment of Residual Disease and Pathologic Complete Response After Neoadjuvant Chemotherapy for Breast Cancer: ACRIN 6657 Trial. AJR Am J Roentgenol. 210(6):1376-1385, 2018
                                        5. Sparano JA et al: Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer. N Engl J Med. ePub, 2018
                                        6. van Steenhoven JEC et al: Conventional pathology versus gene signatures for assessing luminal A and B type breast cancers: Results of a prospective cohort study. Genes (Basel). 9(5), 2018
                                        7. Wibmer AG et al: Trends in oncologic hybrid imaging. Eur J Hybrid Imaging. 2(1):1, 2018
                                        8. Brouckaert O et al: Reproductive profiles and risk of breast cancer subtypes: a multi-center case-only study. Breast Cancer Res. 19(1):119, 2017
                                        9. Chu AJ et al: Imaging Surveillance for Survivors of Breast Cancer: Correlation between Cancer Characteristics and Method of Detection. J Breast Cancer. 20(2):192-197, 2017
                                        10. Plaza MJ et al: Preoperative MRI Evaluation of Axillary Lymph Nodes in Invasive Ductal Carcinoma: Comparison of Luminal A Versus Luminal B Subtypes in a Paradigm Using Ki-67 and Receptor Status. AJR Am J Roentgenol. 208(4):910-915, 2017
                                        11. Yang ZJ et al: The prognostic value of node status in different breast cancer subtypes. Oncotarget. 8(3):4563-4571, 2017
                                        12. Bouzón A et al: Diagnostic accuracy of MRI to evaluate tumour response and residual tumour size after neoadjuvant chemotherapy in breast cancer patients. Radiol Oncol. 50(1):73-9, 2016
                                        13. Cho N: Molecular subtypes and imaging phenotypes of breast cancer. Ultrasonography. 35(4):281-8, 2016
                                        14. Doebar SC et al: Extent of ductal carcinoma in situ according to breast cancer subtypes: a population-based cohort study. Breast Cancer Res Treat. 158(1):179-87, 2016
                                        15. Hylton NM et al: Neoadjuvant Chemotherapy for Breast Cancer: Functional Tumor Volume by MR Imaging Predicts Recurrence-free Survival-Results from the ACRIN 6657/CALGB 150007 I-SPY 1 TRIAL. Radiology. 279(1):44-55, 2016
                                        16. Liu S et al: Is There a Correlation between the Presence of a Spiculated Mass on Mammogram and Luminal A Subtype Breast Cancer? Korean J Radiol. 17(6):846-852, 2016
                                        17. Ulaner GA et al: Molecular Imaging of Biomarkers in Breast Cancer. J Nucl Med. 57 Suppl 1:53S-9S, 2016
                                        18. Francis PA et al: Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med. 372(5):436-46, 2015
                                        19. Grimm LJ et al: Can breast cancer molecular subtype help to select patients for preoperative MR imaging? Radiology. 274(2):352-8, 2015
                                        20. Ha R et al: Breast cancer molecular subtype as a predictor of the utility of preoperative MRI. AJR Am J Roentgenol. 204(6):1354-60, 2015
                                        21. Zhang L et al: Identifying ultrasound and clinical features of breast cancer molecular subtypes by ensemble decision. Sci Rep. 5:11085, 2015
                                        22. Inic Z et al: Difference between Luminal A and Luminal B Subtypes According to Ki-67, Tumor Size, and Progesterone Receptor Negativity Providing Prognostic Information. Clin Med Insights Oncol. 8:107-11, 2014
                                        23. Mazurowski MA et al: Radiogenomic analysis of breast cancer: luminal B molecular subtype is associated with enhancement dynamics at MR imaging. Radiology. 273(2):365-72, 2014
                                        24. Purdie CA et al: Progesterone receptor expression is an independent prognostic variable in early breast cancer: a population-based study. Br J Cancer. 110(3):565-72, 2014
                                        25. Goldhirsch A et al: Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol. 24(9):2206-23, 2013
                                        26. Irshad A et al: Assessing the role of ultrasound in predicting the biological behavior of breast cancer. AJR Am J Roentgenol. 200(2):284-90, 2013
                                        27. Jochelson MS et al: Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology. 266(3):743-51, 2013
                                        28. Bae MS et al: Characteristics of breast cancers detected by ultrasound screening in women with negative mammograms. Cancer Sci. 102(10):1862-7, 2011
                                        29. Early Breast Cancer Trialists' Collaborative Group (EBCTCG) et al: Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 378(9793):771-84, 2011
                                        30. Goldhirsch A et al: Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol. 22(8):1736-47, 2011
                                        31. Jeh SK et al: Correlation of the apparent diffusion coefficient value and dynamic magnetic resonance imaging findings with prognostic factors in invasive ductal carcinoma. J Magn Reson Imaging. 33(1):102-9, 2011
                                        32. McGuire KP et al: MRI staging after neoadjuvant chemotherapy for breast cancer: does tumor biology affect accuracy? Ann Surg Oncol. 18(11):3149-54, 2011
                                        33. Reis-Filho JS et al: Gene expression profiling in breast cancer: classification, prognostication, and prediction. Lancet. 378(9805):1812-23, 2011
                                        34. Tchou J et al: Degree of tumor FDG uptake correlates with proliferation index in triple negative breast cancer. Mol Imaging Biol. 12(6):657-62, 2010
                                        35. Voduc KD et al: Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol. 28(10):1684-91, 2010
                                        36. Au-Yong IT et al: Sonographic correlations with the new molecular classification of invasive breast cancer. Eur Radiol. 19(10):2342-8, 2009
                                        37. Ma H et al: Is there a difference in the association between percent mammographic density and subtypes of breast cancer? Luminal A and triple-negative breast cancer. Cancer Epidemiol Biomarkers Prev. 18(2):479-85, 2009
                                        38. Wiechmann L et al: Presenting features of breast cancer differ by molecular subtype. Ann Surg Oncol. 16:2705-10, 2009
                                        39. Basu S et al: Comparison of triple-negative and estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast carcinoma using quantitative fluorine-18 fluorodeoxyglucose/positron emission tomography imaging parameters: a potentially useful method for disease characterization. Cancer. 112(5):995-1000, 2008
                                        40. Gown AM: Current issues in ER and HER2 testing by IHC in breast cancer. Mod Pathol. 21 Suppl 2:S8-S15, 2008
                                        41. Smid M et al: Subtypes of breast cancer show preferential site of relapse. Cancer Res. 68(9):3108-14, 2008
                                        42. Taneja S et al: The mammographic correlations of a new immunohistochemical classification of invasive breast cancer. Clin Radiol. 63(11):1228-35, 2008
                                        43. Wang Y et al: Estrogen receptor-negative invasive breast cancer: imaging features of tumors with and without human epidermal growth factor receptor type 2 overexpression. Radiology. 246(2):367-75, 2008
                                        44. Yang WT et al: Mammographic features of triple receptor-negative primary breast cancers in young premenopausal women. Breast Cancer Res Treat. 111(3):405-10, 2008
                                        45. Chen JH et al: Magnetic resonance imaging in predicting pathological response of triple negative breast cancer following neoadjuvant chemotherapy. J Clin Oncol. 25(35):5667-9, 2007
                                        46. Gokhale S et al: Assessment of two automated imaging systems in evaluating estrogen receptor status in breast carcinoma. Appl Immunohistochem Mol Morphol. 15(4):451-5, 2007
                                        47. Carey LA et al: Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA. 295(21):2492-502, 2006
                                        48. Cheang MC et al: Immunohistochemical detection using the new rabbit monoclonal antibody SP1 of estrogen receptor in breast cancer is superior to mouse monoclonal antibody 1D5 in predicting survival. J Clin Oncol. 24(36):5637-44, 2006
                                        49. Brenton JD et al: Molecular classification and molecular forecasting of breast cancer: ready for clinical application? J Clin Oncol. 23(29):7350-60, 2005
                                        50. Collett K et al: A basal epithelial phenotype is more frequent in interval breast cancers compared with screen detected tumors. Cancer Epidemiol Biomarkers Prev. 14(5):1108-12, 2005
                                        51. Rouzier R et al: Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res. 11(16):5678-85, 2005
                                        52. Sørlie T: Molecular portraits of breast cancer: tumour subtypes as distinct disease entities. Eur J Cancer. 40(18):2667-75, 2004
                                        53. Wells CA et al: Consistency of staining and reporting of oestrogen receptor immunocytochemistry within the European Union--an inter-laboratory study. Virchows Arch. 445(2):119-28, 2004
                                        54. Layfield LJ et al: Interlaboratory variation in results from immunohistochemical assessment of estrogen receptor status. Breast J. 9(3):257-9, 2003
                                        55. Gajdos C et al: Mammographic appearance of nonpalpable breast cancer reflects pathologic characteristics. Ann Surg. 235(2):246-51, 2002
                                        56. Goldhirsch A et al: Meeting highlights: International Consensus Panel on the Treatment of Primary Breast Cancer. Seventh International Conference on Adjuvant Therapy of Primary Breast Cancer. J Clin Oncol. 19(18):3817-27, 2001
                                        57. Rhodes A et al: Study of interlaboratory reliability and reproducibility of estrogen and progesterone receptor assays in Europe. Documentation of poor reliability and identification of insufficient microwave antigen retrieval time as a major contributory element of unreliable assays. Am J Clin Pathol. 115(1):44-58, 2001
                                        58. Sørlie T et al: Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci U S A. 98(19):10869-74, 2001
                                        59. Elledge RM et al: Estrogen receptor (ER) and progesterone receptor (PgR), by ligand-binding assay compared with ER, PgR and pS2, by immuno-histochemistry in predicting response to tamoxifen in metastatic breast cancer: a Southwest Oncology Group Study. Int J Cancer. 89(2):111-7, 2000
                                        60. Perou CM et al: Molecular portraits of human breast tumours. Nature. 406(6797):747-52, 2000
                                        61. Harvey JM et al: Estrogen receptor status by immunohistochemistry is superior to the ligand-binding assay for predicting response to adjuvant endocrine therapy in breast cancer. J Clin Oncol. 17(5):1474-81, 1999
                                        62. Bevitt DJ et al: New monoclonal antibodies to oestrogen and progesterone receptors effective for paraffin section immunohistochemistry. J Pathol. 183(2):228-32, 1997
                                        63. Allred DC et al: Immunocytochemical analysis of estrogen receptors in human breast carcinomas. Evaluation of 130 cases and review of the literature regarding concordance with biochemical assay and clinical relevance. Arch Surg. 125(1):107-13, 1990
                                        64. Osborne CK et al: The value of estrogen and progesterone receptors in the treatment of breast cancer. Cancer. 46(12 Suppl):2884-8, 1980
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Major types of invasive cancer based on gene expression: Estrogen receptor (ER); progesterone receptor (PR); human epidermal growth factor 2 (HER2, product of ERBB2 gene)
                                                    • Intrinsic subtypes: Luminal A; luminal B HER2(+); luminal B HER2(-); nonluminal HER2; basal-like breast cancer (BLBC)
                                                    • Immunohistochemistry (IHC) surrogate for intrinsic subtype by tumor genomics
                                                    • Luminal A invasive cancers
                                                      • High expression of ER and luminal cytokeratins
                                                      • PR expression in ≥ 20% of tumor cells
                                                      • No overexpression of HER2
                                                      • Low Ki-67 proliferation index (~ < 10%)
                                                    • Luminal B [HER2(+)]
                                                      • ER(+); may be PR(+) or PR(-)
                                                        • Expression of ER and related genes < luminal A
                                                      • Overexpression of HER2 [HER2(+)]
                                                      • Possible overexpression of EGFR
                                                      • Any proliferation index
                                                    • Luminal B [HER2(-)]
                                                      • ER(+) and at least 1of following
                                                        • Negative or low-level (< 20%) PR(+)
                                                        • High proliferation index (Ki-67 ≥ 20%)
                                                    • Concordance of IHC with intrinsic subtype only ~ 64% for luminal tumors
                                                      • Oncotype DX [ER(+) T1-2, N0 and selectively N1 tumors] or MammaPrint [ER(+) or (-), T1-3, N0-1 tumors] → recurrence risk with endocrine therapy alone
                                                      • BluePrint, Prosigna (PAM50) can provide intrinsic subtype if needed for chemotherapy decisions
                                                    • Classic HER2(+) (nonluminal): ER/PR(-), HER2(+)
                                                    • Triple-negative breast cancer (TNBC): ER/PR/HER2(-)
                                                    • Basal-like cancer: ER/PR/HER2(-), express cytokeratins
                                                      • Some tumors with low positivity ER on IHC may cluster with basal-like cancers on gene expression

                                                  IMAGING

                                                  • Mammographic Findings

                                                    • Ultrasonographic Findings

                                                      • MR Findings

                                                        • Nuclear Medicine Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Farshid G et al: Molecular subtypes of screen-detected breast cancer. Breast Cancer Res Treat. 172(1):191-199, 2018
                                                                              2. Francis PA et al: Tailoring Adjuvant Endocrine Therapy for Premenopausal Breast Cancer. N Engl J Med. 379(2):122-137, 2018
                                                                              3. Partridge SC et al: Diffusion-weighted MRI Findings Predict Pathologic Response in Neoadjuvant Treatment of Breast Cancer: The ACRIN 6698 Multicenter Trial. Radiology. 180273, 2018
                                                                              4. Scheel JR et al: MRI, Clinical Examination, and Mammography for Preoperative Assessment of Residual Disease and Pathologic Complete Response After Neoadjuvant Chemotherapy for Breast Cancer: ACRIN 6657 Trial. AJR Am J Roentgenol. 210(6):1376-1385, 2018
                                                                              5. Sparano JA et al: Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer. N Engl J Med. ePub, 2018
                                                                              6. van Steenhoven JEC et al: Conventional pathology versus gene signatures for assessing luminal A and B type breast cancers: Results of a prospective cohort study. Genes (Basel). 9(5), 2018
                                                                              7. Wibmer AG et al: Trends in oncologic hybrid imaging. Eur J Hybrid Imaging. 2(1):1, 2018
                                                                              8. Brouckaert O et al: Reproductive profiles and risk of breast cancer subtypes: a multi-center case-only study. Breast Cancer Res. 19(1):119, 2017
                                                                              9. Chu AJ et al: Imaging Surveillance for Survivors of Breast Cancer: Correlation between Cancer Characteristics and Method of Detection. J Breast Cancer. 20(2):192-197, 2017
                                                                              10. Plaza MJ et al: Preoperative MRI Evaluation of Axillary Lymph Nodes in Invasive Ductal Carcinoma: Comparison of Luminal A Versus Luminal B Subtypes in a Paradigm Using Ki-67 and Receptor Status. AJR Am J Roentgenol. 208(4):910-915, 2017
                                                                              11. Yang ZJ et al: The prognostic value of node status in different breast cancer subtypes. Oncotarget. 8(3):4563-4571, 2017
                                                                              12. Bouzón A et al: Diagnostic accuracy of MRI to evaluate tumour response and residual tumour size after neoadjuvant chemotherapy in breast cancer patients. Radiol Oncol. 50(1):73-9, 2016
                                                                              13. Cho N: Molecular subtypes and imaging phenotypes of breast cancer. Ultrasonography. 35(4):281-8, 2016
                                                                              14. Doebar SC et al: Extent of ductal carcinoma in situ according to breast cancer subtypes: a population-based cohort study. Breast Cancer Res Treat. 158(1):179-87, 2016
                                                                              15. Hylton NM et al: Neoadjuvant Chemotherapy for Breast Cancer: Functional Tumor Volume by MR Imaging Predicts Recurrence-free Survival-Results from the ACRIN 6657/CALGB 150007 I-SPY 1 TRIAL. Radiology. 279(1):44-55, 2016
                                                                              16. Liu S et al: Is There a Correlation between the Presence of a Spiculated Mass on Mammogram and Luminal A Subtype Breast Cancer? Korean J Radiol. 17(6):846-852, 2016
                                                                              17. Ulaner GA et al: Molecular Imaging of Biomarkers in Breast Cancer. J Nucl Med. 57 Suppl 1:53S-9S, 2016
                                                                              18. Francis PA et al: Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med. 372(5):436-46, 2015
                                                                              19. Grimm LJ et al: Can breast cancer molecular subtype help to select patients for preoperative MR imaging? Radiology. 274(2):352-8, 2015
                                                                              20. Ha R et al: Breast cancer molecular subtype as a predictor of the utility of preoperative MRI. AJR Am J Roentgenol. 204(6):1354-60, 2015
                                                                              21. Zhang L et al: Identifying ultrasound and clinical features of breast cancer molecular subtypes by ensemble decision. Sci Rep. 5:11085, 2015
                                                                              22. Inic Z et al: Difference between Luminal A and Luminal B Subtypes According to Ki-67, Tumor Size, and Progesterone Receptor Negativity Providing Prognostic Information. Clin Med Insights Oncol. 8:107-11, 2014
                                                                              23. Mazurowski MA et al: Radiogenomic analysis of breast cancer: luminal B molecular subtype is associated with enhancement dynamics at MR imaging. Radiology. 273(2):365-72, 2014
                                                                              24. Purdie CA et al: Progesterone receptor expression is an independent prognostic variable in early breast cancer: a population-based study. Br J Cancer. 110(3):565-72, 2014
                                                                              25. Goldhirsch A et al: Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol. 24(9):2206-23, 2013
                                                                              26. Irshad A et al: Assessing the role of ultrasound in predicting the biological behavior of breast cancer. AJR Am J Roentgenol. 200(2):284-90, 2013
                                                                              27. Jochelson MS et al: Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology. 266(3):743-51, 2013
                                                                              28. Bae MS et al: Characteristics of breast cancers detected by ultrasound screening in women with negative mammograms. Cancer Sci. 102(10):1862-7, 2011
                                                                              29. Early Breast Cancer Trialists' Collaborative Group (EBCTCG) et al: Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 378(9793):771-84, 2011
                                                                              30. Goldhirsch A et al: Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol. 22(8):1736-47, 2011
                                                                              31. Jeh SK et al: Correlation of the apparent diffusion coefficient value and dynamic magnetic resonance imaging findings with prognostic factors in invasive ductal carcinoma. J Magn Reson Imaging. 33(1):102-9, 2011
                                                                              32. McGuire KP et al: MRI staging after neoadjuvant chemotherapy for breast cancer: does tumor biology affect accuracy? Ann Surg Oncol. 18(11):3149-54, 2011
                                                                              33. Reis-Filho JS et al: Gene expression profiling in breast cancer: classification, prognostication, and prediction. Lancet. 378(9805):1812-23, 2011
                                                                              34. Tchou J et al: Degree of tumor FDG uptake correlates with proliferation index in triple negative breast cancer. Mol Imaging Biol. 12(6):657-62, 2010
                                                                              35. Voduc KD et al: Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol. 28(10):1684-91, 2010
                                                                              36. Au-Yong IT et al: Sonographic correlations with the new molecular classification of invasive breast cancer. Eur Radiol. 19(10):2342-8, 2009
                                                                              37. Ma H et al: Is there a difference in the association between percent mammographic density and subtypes of breast cancer? Luminal A and triple-negative breast cancer. Cancer Epidemiol Biomarkers Prev. 18(2):479-85, 2009
                                                                              38. Wiechmann L et al: Presenting features of breast cancer differ by molecular subtype. Ann Surg Oncol. 16:2705-10, 2009
                                                                              39. Basu S et al: Comparison of triple-negative and estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast carcinoma using quantitative fluorine-18 fluorodeoxyglucose/positron emission tomography imaging parameters: a potentially useful method for disease characterization. Cancer. 112(5):995-1000, 2008
                                                                              40. Gown AM: Current issues in ER and HER2 testing by IHC in breast cancer. Mod Pathol. 21 Suppl 2:S8-S15, 2008
                                                                              41. Smid M et al: Subtypes of breast cancer show preferential site of relapse. Cancer Res. 68(9):3108-14, 2008
                                                                              42. Taneja S et al: The mammographic correlations of a new immunohistochemical classification of invasive breast cancer. Clin Radiol. 63(11):1228-35, 2008
                                                                              43. Wang Y et al: Estrogen receptor-negative invasive breast cancer: imaging features of tumors with and without human epidermal growth factor receptor type 2 overexpression. Radiology. 246(2):367-75, 2008
                                                                              44. Yang WT et al: Mammographic features of triple receptor-negative primary breast cancers in young premenopausal women. Breast Cancer Res Treat. 111(3):405-10, 2008
                                                                              45. Chen JH et al: Magnetic resonance imaging in predicting pathological response of triple negative breast cancer following neoadjuvant chemotherapy. J Clin Oncol. 25(35):5667-9, 2007
                                                                              46. Gokhale S et al: Assessment of two automated imaging systems in evaluating estrogen receptor status in breast carcinoma. Appl Immunohistochem Mol Morphol. 15(4):451-5, 2007
                                                                              47. Carey LA et al: Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA. 295(21):2492-502, 2006
                                                                              48. Cheang MC et al: Immunohistochemical detection using the new rabbit monoclonal antibody SP1 of estrogen receptor in breast cancer is superior to mouse monoclonal antibody 1D5 in predicting survival. J Clin Oncol. 24(36):5637-44, 2006
                                                                              49. Brenton JD et al: Molecular classification and molecular forecasting of breast cancer: ready for clinical application? J Clin Oncol. 23(29):7350-60, 2005
                                                                              50. Collett K et al: A basal epithelial phenotype is more frequent in interval breast cancers compared with screen detected tumors. Cancer Epidemiol Biomarkers Prev. 14(5):1108-12, 2005
                                                                              51. Rouzier R et al: Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res. 11(16):5678-85, 2005
                                                                              52. Sørlie T: Molecular portraits of breast cancer: tumour subtypes as distinct disease entities. Eur J Cancer. 40(18):2667-75, 2004
                                                                              53. Wells CA et al: Consistency of staining and reporting of oestrogen receptor immunocytochemistry within the European Union--an inter-laboratory study. Virchows Arch. 445(2):119-28, 2004
                                                                              54. Layfield LJ et al: Interlaboratory variation in results from immunohistochemical assessment of estrogen receptor status. Breast J. 9(3):257-9, 2003
                                                                              55. Gajdos C et al: Mammographic appearance of nonpalpable breast cancer reflects pathologic characteristics. Ann Surg. 235(2):246-51, 2002
                                                                              56. Goldhirsch A et al: Meeting highlights: International Consensus Panel on the Treatment of Primary Breast Cancer. Seventh International Conference on Adjuvant Therapy of Primary Breast Cancer. J Clin Oncol. 19(18):3817-27, 2001
                                                                              57. Rhodes A et al: Study of interlaboratory reliability and reproducibility of estrogen and progesterone receptor assays in Europe. Documentation of poor reliability and identification of insufficient microwave antigen retrieval time as a major contributory element of unreliable assays. Am J Clin Pathol. 115(1):44-58, 2001
                                                                              58. Sørlie T et al: Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci U S A. 98(19):10869-74, 2001
                                                                              59. Elledge RM et al: Estrogen receptor (ER) and progesterone receptor (PgR), by ligand-binding assay compared with ER, PgR and pS2, by immuno-histochemistry in predicting response to tamoxifen in metastatic breast cancer: a Southwest Oncology Group Study. Int J Cancer. 89(2):111-7, 2000
                                                                              60. Perou CM et al: Molecular portraits of human breast tumours. Nature. 406(6797):747-52, 2000
                                                                              61. Harvey JM et al: Estrogen receptor status by immunohistochemistry is superior to the ligand-binding assay for predicting response to adjuvant endocrine therapy in breast cancer. J Clin Oncol. 17(5):1474-81, 1999
                                                                              62. Bevitt DJ et al: New monoclonal antibodies to oestrogen and progesterone receptors effective for paraffin section immunohistochemistry. J Pathol. 183(2):228-32, 1997
                                                                              63. Allred DC et al: Immunocytochemical analysis of estrogen receptors in human breast carcinomas. Evaluation of 130 cases and review of the literature regarding concordance with biochemical assay and clinical relevance. Arch Surg. 125(1):107-13, 1990
                                                                              64. Osborne CK et al: The value of estrogen and progesterone receptors in the treatment of breast cancer. Cancer. 46(12 Suppl):2884-8, 1980