Department of Genetics, University of Nebraska Medical Center, Omaha, USA.
Cancer Biol Ther. 2010 Nov 15;10(10):955-60. doi: 10.4161/cbt.10.10.13879.
Increased understanding of the molecular heterogeneity that is intrinsic to the various subtypes of breast cancer will likely shape the future of breast cancer diagnosis, prognosis, and treatment. Advances in the field over the last several decades have been remarkable and have clearly translated into better patient care as evidenced by the earlier detection, better prognosis, and new targeted therapies. There have been two recent advances in the breast cancer research field that have lead to paradigm shifts: first, the identification of intrinsic breast tumor subtypes, which has changed the way we think about breast cancer and second, the recent characterization of cancer stem cells (CSCs), which are suspected to be responsible for tumor initiation, recurrence and resistance to therapy, have opened new exciting avenues to think about breast cancer therapeutic strategies. While these advances constitute major paradigm shifts within the research realm, the clinical arena has yet to adopt and apply our understanding of the molecular basis of the disease to early diagnosis, prognosis and therapy of breast cancers. Here, we will review the current clinical approach to classification of breast cancers, newer molecular-based classification schemes, and potential future of biomarkers representing a functional classification of breast cancer.
对乳腺癌各种亚型内在的分子异质性的认识不断提高,很可能会影响乳腺癌诊断、预后和治疗的未来。过去几十年中,该领域的进展令人瞩目,并通过早期检测、更好的预后和新的靶向治疗得到了明确体现,从而改善了患者的治疗效果。乳腺癌研究领域最近有两项进展带来了范式转变:首先,内在乳腺癌肿瘤亚型的鉴定改变了我们对乳腺癌的看法;其次,最近对癌症干细胞(CSC)的特征描述,被怀疑是肿瘤发生、复发和对治疗耐药的原因,为思考乳腺癌治疗策略开辟了新的途径。虽然这些进展构成了研究领域的重大范式转变,但临床领域尚未采用和应用我们对疾病分子基础的理解,将其应用于乳腺癌的早期诊断、预后和治疗。在这里,我们将回顾当前乳腺癌分类的临床方法、基于分子的新分类方案,以及代表乳腺癌功能分类的潜在未来生物标志物。