Early breast cancer (BC) is the definition applied to breast-confined tumors with or without limited involvement of locoregional lymph nodes. While risk stratification is essential for guiding clinical decisions, it can be a complex endeavor in these patients due to the absence of comprehensive guidelines. Histopathological analysis and biomarker assessment play a pivotal role in defining patient outcomes. Traditional histological criteria such as tumor size, lymph node involvement, histological type and grade, lymphovascular invasion, and immune cell infiltration are significant prognostic indicators. In addition to the hormone receptor, HER2, and—in specific scenarios—BRCA1/2 testing, molecular subtyping through gene expression profiling provides valuable insights to tailor clinical decision-making. The emergence of “omics” technologies, applicable to both tissue and liquid biopsy samples, has broadened our arsenal for evaluating the risk of early BC. However, a pressing need remains for standardized methodologies and integrated pathological models that encompass multiple analytical dimensions. In this study, we provide a detailed examination of the existing strategies for early BC risk stratification, intending to serve as a practical guide for histopathologists and molecular pathologists.
早期乳腺癌（BC）是指局限于乳房的肿瘤，无论是否伴有局部淋巴结的有限受累。尽管风险分层对于指导临床决策至关重要，但由于缺乏全面的指南，对这些患者进行风险分层可能是一项复杂的任务。组织病理学分析和生物标志物评估在确定患者预后方面起着关键作用。传统的组织学标准，如肿瘤大小、淋巴结受累情况、组织学类型和分级、淋巴血管侵犯以及免疫细胞浸润，是重要的预后指标。除了激素受体、HER2检测以及特定情况下的BRCA1/2检测外，通过基因表达谱进行的分子分型为定制临床决策提供了宝贵的见解。适用于组织和液体活检样本的“组学”技术的出现，扩大了评估早期乳腺癌风险的工具库。然而，目前仍迫切需要标准化的方法和涵盖多个分析维度的整合病理学模型。在本研究中，我们对现有的早期乳腺癌风险分层策略进行了详细探讨，旨在为组织病理学家和分子病理学家提供实用指南。
Advances in Early Breast Cancer Risk Profiling: From Histopathology to Molecular Technologies
肿瘤(癌症)患者之家