Department of Pathology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
Cell Oncol (Dordr). 2011 Apr;34(2):71-88. doi: 10.1007/s13402-011-0010-3. Epub 2011 Feb 19.
Hereditary breast cancer runs in families where several members in different generations are affected. Most of these breast cancers are caused by mutations in the high penetrance genes BRCA1 and BRCA2 accounting for about 5% of all breast cancers. Other genes that include CHEK2, PTEN, TP53, ATM, STK11/LKB1, CDH1, NBS1, RAD50, BRIP1 and PALB2 have been described to be high or moderate penetrance breast cancer susceptibility genes, all contributing to the hereditary breast cancer spectrum. However, in still a part of familial hereditary breast cancers no relationship to any of these breast cancer susceptibility genes can be found. Research on new susceptibility genes is therefore ongoing.
In this review we will describe the function of the today known high or moderate penetrance breast cancer susceptibility genes and the consequences of their mutated status. Furthermore, we will focus on the histology, the immunophenotype and genotype of breast cancers caused by mutations in BRCA1 and BRCA2 genes and the other high or moderate penetrance breast cancer susceptibility genes. Finally, an overview of the clinical implications of hereditary breast cancer patients will be provided.
This information leads to a better understanding of the morphological, immunohistochemical and molecular characteristics of different types of hereditary breast cancers. Further, these characteristics offer clues for diagnosis and new therapeutic approaches.
遗传性乳腺癌在几代人中都有多个成员受到影响的家庭中发生。这些乳腺癌大多数是由高外显率基因 BRCA1 和 BRCA2 的突变引起的,约占所有乳腺癌的 5%。其他基因,包括 CHEK2、PTEN、TP53、ATM、STK11/LKB1、CDH1、NBS1、RAD50、BRIP1 和 PALB2,已被描述为高或中度外显率乳腺癌易感基因,都有助于遗传性乳腺癌谱的形成。然而,在一部分家族遗传性乳腺癌中,仍然无法发现与任何这些乳腺癌易感基因有关的关系。因此,对新的易感基因的研究仍在进行中。
在这篇综述中,我们将描述今天已知的高或中度外显率乳腺癌易感基因的功能及其突变状态的后果。此外,我们将重点介绍 BRCA1 和 BRCA2 基因突变以及其他高或中度外显率乳腺癌易感基因引起的乳腺癌的组织学、免疫表型和基因型。最后,提供遗传性乳腺癌患者的临床意义概述。
这些信息有助于更好地理解不同类型遗传性乳腺癌的形态学、免疫组织化学和分子特征。此外,这些特征为诊断和新的治疗方法提供了线索。