Optimal Assessment of Metastatic Breast Carcinoma: The Value of Cytopathology Combined with Molecular Analysis

Metastatic breast cancer (MBC) remains in most cases an incurable disease with genetic complexity and heterogeneity. Improvements classification management have been introduced, addition to the development of endocrine anti-HER2 targeted therapies. Currently, efforts are being made delineate best approach for genomic landscape MBC and, as result, molecular therapeutic targets. Here, we highlight recent developments cytopathology MBC, discussing cytological diagnostic approaches characterization hallmarks, such immunocytochemistry biomarkers. Cytological material can be processed ancillary testing purposes. Reassessment receptor status is indicated due changes tumor biology metastatic presentation. PD-L1 expression only approved biomarker predicting immune checkpoint inhibitor response TNBC, evaluated by immunostaining. The feasibility applying assays samples recommended, adoption a combined positive score. Non-formalin provide higher purity, cellular yield, better fraction single-multi gene assays. In tests enable personalized therapy PIK3CA, NTRK fusion genes, MSI. Cytopathology analysis must performed effectively routine clinical practice, through procedure standardization experience dissemination.