In the last decade, the tumor microenvironment has shown to play an important role in tumor progression. Still, no markers concerning the microenvironment have been implemented in clinical decision... Show moreIn the last decade, the tumor microenvironment has shown to play an important role in tumor progression. Still, no markers concerning the microenvironment have been implemented in clinical decision making. The research presented in this thesis emphasizes the prognostic value of the tumor-stroma ratio (TSR), a method focusing on the tumor microenvironment. The TSR assessment is performed by the scoring method developed by Mesker et al. on routine hematoxylin and eosin (H&E) stained tissue slides of the primary tumor. Various validation studies demonstrated that the TSR is a reliable, simple, quick and inexpensive parameter with a good to a very good inter-observer agreement. The new insights presented in this thesis contribute to a better understanding of the role of the TSR on predicting clinical outcome in subgroups of breast cancer patients and in combination with other prognostic parameters. Furthermore, the described research is important for further research toward clinical implementation of the TSR and might finally be useful for decision-making regarding therapy. Moreover, molecular research of the stromal compartment in the near future is desirable for the development of new diagnostic, prognostic, monitoring and therapeutic markers. Show less
