IMMUNOHISTOCHEMICAL MARKERS AND THEIR PROGNOSTIC SIGNIFICANCE IN BREAST CANCER: A LITERATURE REVIEW

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Relevance. Breast cancer (BC) is one of the most common malignant neoplasms in women and retains a high medical and social significance. The purpose of the review was to summarize and analyze the current literature data on clinical, morphological and immunohistochemical factors that determine the prognosis in breast cancer, with special attention to the expression of estrogen receptors (ER), progesterone (PR), HER2 and the index of proliferative activity Ki-67. Materials and methods. The analysis of modern domestic and foreign publications on the prognostic value of clinical, morphological, immunohistochemical and molecular biological characteristics of breast cancer was carried out. Particular attention is paid to the data of systematic reviews, meta-analyses and international clinical guidelines characterizing the role of tumor size, the state of regional lymph nodes, the degree of differentiation, ER-, PR-, HER2-status and Ki-67 in assessing the risk of recurrence and progression diseases. Results. The analysis of the literature showed that the prognosis of breast cancer is determined by the combination of anatomical and biological characteristics of the tumor. The size of the primary focus, regional lymph node involvement, and clinical stage remain of fundamental importance. Expression of ER and PR is associated with the hormonal sensitivity of the tumor and has an important prognostic and predictive value. HER2 is both a significant prognostic and predictive marker that determines the possibility of using targeted therapy. Elevated levels of Ki-67 reflect high proliferative activity and are associated with more aggressive tumor biological behavior and a poor prognosis in most studies. At the same time, the variability of methods for determining Ki-67 and interpreting boundary values limits the possibility of its isolated use as a prognostic criterion. Conclusion. The combined determination of ER, PR, HER2 and Ki-67, taking into account the stage, size of the tumor, lymph nodes and the degree of differentiation, allows a more objective assessment of the biological potential of the tumor and the individual risk of recurrence. Further improvement of complex prognostic models, including immunohistochemical and molecular genetic indicators is a promising area of personalized oncology.