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The choice of endocrine therapy and chemotherapy used in the treatment of breast cancer is largely empirically derived, based on data obtained from clinical trials [32]. However, patients with the same tumor pathology may not respond to the same cytotoxic drugs. Steroid hormone receptors, used to predict hormone responsiveness of breast tumors, greatly improve the probability of response, but does not ensure that a patient will benefit from endocrine manipulations. Inappropriate treatments result in valuable time lost for alternative therapy and unnecessary suffering from side effects of antineoplastic agents. A major aspect of breast cancer biology responsible for therapeutic failures is tumor heterogeneity; tumors contain varying numbers of hormone- and drug-responsive and hormone- and drug-resistant cells [47]. |
