Circulating tumor cells (CTCs) in breast cancer patients can be detected by Cell Search system. Results from recent studies suggested that CTCs level might serve as a prognostic marker and be used in the early assessment of therapeutic response in patients with metastatic breast cancer. However the role of CTCs in early stage breast cancer is not well established. Large prospective trials are needed to further understand its biological characteristics and to confirm its role as a predictive and prognostic marker.

Triple-negative breast cancer (TNBC) is a heterogeneous disease. Recently, the development of a gene expression profile fa-cilitated the re-classification of TNBC into six new subtypes, which show varied sensitivities to different therapies. In the era of preci-sion medicine, precision therapy may be directed at various potentially actionable molecular mutations in different subtypes of TNBC.

With the development of the next generation sequencing technology, considerable attention has been paid to the utility of circulating tumor DNA (ctDNA) detection in breast cancer. There are many clinical trials showed the ctDNA detection is a potential biomarker for the diagnosis, management and prognosis of breast cancer. ctDNA detection can provide a more accurate diagnosis for patients to guide clinical treatment in precision medicine era.

With development of molecular biology,breast cancer has entered an era of molecular classifi-cation,thus making biomarker based personalized medicine is the trend of breast cancer treatment.HER2-posi-tive breast cancer of high invasiveness and bad prognosis accounts for 20%~30%.Targeting HER2,trastuzumab is the first humanized monoclonal antibody which can improve the prognosis of HER2-positive patients and it is recommended by guidelines and expert consensus at home and abroad for anti-HER2 therapy in any stage.How-ever,the cardiotoxicity,de novo resistance and acquired resistance of trastuzumab make the clinician to explore the second line anti-HER2 therapy.Lapatinib is the first FDA approved and HER1,HER2 double-targeting tyrosine kinase inhibitor which can be a better choice after failure with trastuzumab.This article reviews the appli-cation,some clinical and mechanism of drug resistance researches of Lapatinib.

Breast cancer is the most common malignant tumor in women, bone related events (SREs), such as bone pain, pathological fracture and so on, can affect seriously the quality of life.Experts in Chinese Anti-Cancer Association, Committee of Breast Cancer Society (CACA-CBCS) discussed the Consensus on the Diagnosis and Treatment of Bone Metastasis and Skeletal Related Diseases in Breast Cancer (2014 version), here reflections on several hot issues were explored.

The utility of circulating tumor cells in breast cancer has been paid more attention. There are many clinical trials all over the world which concerned the whole course of breast cancer. Although the value of detecting circulating tumor cells is different at each stage of breast cancer, the advantage is significant compared with traditional methods in monitoring and evaluating diseases status. Nowadays the treatments of breast cancer are classiifed and individualized, it is possible to ifnd the most timely and optimized regimens after detecting the amount and characteristics of circulating tumor cells.

Circulating tumor markers have been paid more attention in the application of the treatment for breast cancer, the level of which has extended from protein to gene, including traditional tumor markers, HER-2 extracellular domain, circulating tumor cells, circulating tumor DNA (ctDNA), circulating RNA (ctRNA) and so on. As “liquid detection”, the detection of circulating tumor markers with real-time dynamic, easy operation, good reproducibility and other advantages are widely used in aiding early diagnosis, determining prognosis, prospectively predicting response or resistance to speciifc therapies, surveillance after primary surgery, and monitoring therapy in patients with advanced disease, The further study of circulating tumor markers may contribute to patient’s individual treatment.

Taxol is one of the most active agent in metastatic breast cancer. Taxol is also an excellent choice for combination therapy by its unique mechanism of action and favorable toxicity profile. Numerous phase II clinical studies have combined taxol with other active agents such as the anthracyclines, gemcitabine, carboplatin and Herceptin. In the adjuvant chemotherapy for early stage breast cancer, two large international clinical trials demonstrated the role of taxol in early breast cancer. CALGB 9344 demonstrated the addition of four cycles of taxol after the completion of a standard course of CA improves the disease-free and overall survival of patients with early breast cancer. CALGB 9741 showed dose density chemotherapy of taxol improves clinical outcomes significantly, while sequential chemotherapy is as effective as concurrent chemotherapty.

Objective To investigate the expression of tumor suppressor gene PTEN in breast carcinomas and its significance. Methods Immunohistochemical method was used to detect the expression of PTEN gene in 146 cases of breast carcinoma and 10 specimens of normal breast tissue closely adjacent to carcinoma. Results It was showed that PTEN gene was expressed in all 10 specimens of breast tissue closely adjacent to carcinoma. Expression of PTEN was localized in cytoplasm and nuclei of epithelial cells of lobular acini and epithelial cells of ducts. The rate of PTEN expression was 57.5% (84/146) in breast carcinoma. Expression of PTEN was related to tumor size, pathological stage, and the expression of ER and PR of breast cancer. The 2-year disease free survival of PTEN high expression breast cancer patients was superior to those with low expression (P

The rigorous randomized clinical trials and qualified real world evidence have improved the domestic standardized diagnosis and therapy. Meanwhile, the recent consensus and guideline integrated with Chinese realities have also promoted the breast cancer therapy. To expound our views and to provide suggestions for the revision of breast cancer guideline of Chinese Society of Clinical Oncology, we select ten hot issues to discuss with our experience.