Cadoo K A, Fornier M N, Morris P G
The Breast Cancer Medicine Service Memorial Sloan Kettering Cancer Center, Weill Medical College of Cornell University, New York, USA -
Q J Nucl Med Mol Imaging. 2013 Dec;57(4):312-21.
Breast cancer is comprised of a number of complex and heterogeneous subtypes with differing clinical behavior and outcomes. In recent years, significant advances have been made in discerning the molecular drivers of this disease, and characterizing distinct subtypes of breast cancer based on gene expression profiles. These advances have begun to translate into greater individualization of treatment for patients. Although these advances have shaped our understanding of the underlying biology of breast cancer, most clinical decisions are currently based on tumor expression of the estrogen receptor (ER), progesterone receptor (PR) and the human epidermal growth factor receptor 2 (HER2). These biomarkers have prognostic and predictive significance in breast cancer and have important implications for tumor growth and metastatic patterns. In this review, we focus on the three broad phenotypes of breast cancer used in clinical practice; ER/PR positive, HER2 positive and triple negative breast cancer (TNBC), which is characterized by lack of expression of ER, PR and HER2. We discuss the influence of these tumor-related factors as well as histological subtype, on the potential for breast cancer recurrence and patterns of disease spread.
乳腺癌由多种复杂且异质性的亚型组成，具有不同的临床行为和预后。近年来，在识别该疾病的分子驱动因素以及基于基因表达谱对乳腺癌不同亚型进行特征描述方面取得了重大进展。这些进展已开始转化为针对患者更具个体化的治疗。尽管这些进展塑造了我们对乳腺癌潜在生物学特性的理解，但目前大多数临床决策仍基于雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER2）的肿瘤表达情况。这些生物标志物在乳腺癌中具有预后和预测意义，对肿瘤生长和转移模式具有重要影响。在本综述中，我们重点关注临床实践中使用的乳腺癌三种广泛的表型；ER/PR阳性、HER2阳性和三阴性乳腺癌（TNBC），其特征是缺乏ER、PR和HER2的表达。我们讨论这些肿瘤相关因素以及组织学亚型对乳腺癌复发可能性和疾病传播模式的影响。
