Wilson Natalie, Ironside Alastair, Diana Anna, Oikonomidou Olga
Cancer Research UK, Edinburgh Centre, MRC Institute Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom.
Edinburgh Cancer Centre, Western General Hospital, Department of Pathology, NHS Lothian, Edinburgh, United Kingdom.
Front Oncol. 2021 Jan 15;10:591399. doi: 10.3389/fonc.2020.591399. eCollection 2020.
Invasive lobular carcinoma accounts for 5%-15% of all invasive breast cancers, with a marked increase in incidence rates over the past two decades. Distinctive biological hallmarks of invasive lobular carcinoma include the loss of cell adhesion molecule E-cadherin leading to cells with a discohesive morphology, proliferating into single-file strands and estrogen receptor positivity. These key molecular features can make diagnosis difficult, as invasive lobular carcinoma is challenging to detect both physically and with current standard imaging. Treatment of invasive lobular carcinoma strongly favors endocrine therapy due to low chemosensitivity and lower rates of pathological response as a result. This review will summarize the distinct biological and molecular features of invasive lobular carcinoma, focusing on the diagnostic challenges faced and the subsequent surgical and medical management strategies. Prospective therapeutic options will also be explored, highlighting how furthering our understanding of the unique biology of lobular breast carcinoma is essential in guiding and informing the treatment of patients in the future.
浸润性小叶癌占所有浸润性乳腺癌的5%-15%,在过去二十年中发病率显著上升。浸润性小叶癌独特的生物学特征包括细胞粘附分子E-钙粘蛋白的缺失,导致细胞形态分散,呈单列增殖以及雌激素受体阳性。这些关键的分子特征会使诊断变得困难,因为浸润性小叶癌无论是通过体格检查还是目前的标准影像学检查都很难被发现。由于化疗敏感性低且病理反应率较低,浸润性小叶癌的治疗强烈倾向于内分泌治疗。本综述将总结浸润性小叶癌独特的生物学和分子特征,重点关注所面临的诊断挑战以及随后的手术和药物管理策略。还将探索前瞻性治疗选择,强调进一步了解小叶乳腺癌的独特生物学特性对于指导和告知未来患者的治疗至关重要。