Breast cancer encompasses a group of very heterogeneous diseases which can be demonstrated at the molecular histopathologic and clinical levels. The heterogeneity at the molecular level has been demonstrated by reproducible differences in the frequencies and magnitudes of genomic aberrations and by differential gene expression among breast carcinomas even those with similar histology. Studies on whole-genome analysis using expression microarray have revolutionized our understanding of breast carcinomas which has led to the discovery of 5 distinct subtypes of breast carcinomas (Luminal A Luminal B HER2 over-expression Basal-like Normal-like) each with unique recognizable phenotypes and clinical outcomes. Subsequent studies have shown that breast carcinomas can also be divided into 5 similar subgroups using immune histochemical (IHC)analysis as a surrogate with a limited panel of antibody markers (including ER PR HER2 CK5/6 and EGFR). These subgroups have distinguishing features closely associated with subtypes defined by gene expression profiling including distinct clinical outcomes different responses to adjuvant therapy and different patterns of metastatic recurrence
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