New Precision In Breast Cancer Treatment
By Susan Fineberg, MD
Section Head of Breast Pathology and Attending Pathologist at Montefiore Einstein Comprehensive Cancer Center
Bronx Voice
October 14, 2025
BRONX - Each year during Breast Cancer Awareness Month, we’re reminded about the importance of screening mammograms to detect breast cancer earlier, when there’s a greater chance for a cure and less invasive treatments are available. In addition to cancer screening, education about breast cancer types, stages, and treatment options can help alleviate fear that can prevent individuals from scheduling a screening appointment.
This article reviews breast cancer diagnosis terminology and customized treatment options that are making a positive impact on outcomes.
Breast Cancer Pathology
After a mammography, a biopsy may be needed to determine the nature of a finding. Pathologists, medical doctors who examine tissues, cells, and body fluids through laboratory tests, identify traits from the biopsy to guide treatment for individualized care.
Before a breast biopsy or surgery, it’s a good idea to ask whether the pathologists at your hospital or clinic specialize in breast cancer. Expertise in breast pathology can lead to more precise diagnoses and personalized treatment recommendations. You may also want to ask if the hospital or clinic has a pathology board or tumor board. These expert panels meet to evaluate complex or unusual cases to help ensure the most accurate diagnosis and best possible care plan.
A breast cancer diagnosis is often described in terms of stage—a number that signals how advanced the cancer is. But no two breast cancers are alike. Each tumor carries distinct characteristics that affect how it behaves and responds to treatment. Understanding a tumor’s grade, biomarkers, and type helps explain how treatment is personalized.
Biomarkers are unique molecules in a tumor, like genes and proteins, that give doctors important clues about how the cancer cells may respond to different treatments. Pathologists routinely test for three key biomarkers: estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2).
Cancers that test positive for these markers are more likely to respond to targeted therapies that block their effects, which can be used alone or in combination with other treatments like chemotherapy and radiation therapy. For instance, a cancer expressing ER can be treated with therapies that block estrogen. Cancers that test negative for ER, PR, and HER2 are called triple negative breast cancer and tend to have a more aggressive behavior, requiring a different treatment approach.
Understanding Breast Cancer & Available Treatments
Breast cancer arises from the milk producing ducts or glandular tissue of the breast. Non-invasive cancer, called ductal carcinoma in situ (DCIS), is limited to the breast ducts. DCIS is generally treated with surgery with or without radiation therapy, and studies are underway to evaluate active monitoring, utilizing more frequent imaging instead of surgery. Invasive cancer has spread beyond the breast ducts into the surrounding tissue of the breast. Invasive cancer may also spread to other parts of the body, which is why invasive cancer requires more aggressive treatment than DCIS.
Home to one of the East Coast’s leading clinical labs, Montefiore Einstein’s Department of Pathology is known for deep expertise in breast diseases. We perform both biomarker and advanced molecular testing on breast cancer tissues, allowing for detection of specific genetic alterations unique to a patient’s tumor, and our pathologists continue to lead the way in the development of an array of new biomarkers to improve the determination of both prognosis and personalized therapy therapies. At Montefiore Einstein Comprehensive Cancer Center we are committed to moving faster than cancer by providing personalized, comprehensive care for every patient.
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