[Biological prognostic factors of cancers of the breast and their consequences on the therapeutic choice]

Abstract

The value of prognostic factors can be measured by their influence on the therapeutic decision. Today, with the exception of clinical stage (TNM classification) and to a certain extent estrogen receptors, prognostic factors have little or no application in the clinical practice. The great number of parameters and the discrepancies between various studies may provide some explanations. By the study of the genetic evolution of breast cancers at the chromosomal level, we propose an approach to the understanding of the redundancy of prognostic factors, often noted by the authors. The consequences on the multiparametric statistical methodology are also discussed. Finally, by distinguishing between prognostic factors (predicting survival) and predictive factors (related to treatment response), we hope to provide indications for a better use of the progress in our knowledge on the biology of breast cancers.