Sakibuzzaman Md, Mahmud Shahriar, Afroze Tanzina, Fathma Sawsan, Zakia Ummul Barakat, Afroz Sabrina, Zafar Farzina, Hossain Maksuda, Barua Amit, Akter Sabiha, Chowdhury Hasanul Islam, Ahsan Eram, Eshan Shayet Hossain, Fariza Tasnuva Tarannum
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Sher-E-Bangla Medical College and Hospital, Barisal, Bangladesh.
Int J Neurosci. 2023 May;133(5):544-554. doi: 10.1080/00207454.2021.1935929. Epub 2023 Feb 5.
Despite the advances in diagnosis and management of breast cancer, metastasis has been responsible for the staggering percentage of breast cancer-related death. Mortality threat can be explained mostly by the lack of proper understanding of the diversity of pathological features and underlying mechanism of breast cancer metastasis and effective targeted therapy. Breast cancer stem cells (BCSCs) are the potential source of tumor cells spread to distant organs. BCSCs targeted therapy can suppress the breast cancer progression to metastasis. Spreading of tumor cells to the bone, lung, liver, and brain occurs through a distinct non-random process; called metastasis organotropism. Recently, brain metastasis in breast cancer patients has been detected more frequently, causing a significant clinical burden. BRCA1 and BRCA2 associated breast cancers carry a remarkably higher propensity of CNS metastasis. BRCA1 and BRCA2 associated breast cancers commonly have the propensity to be the triple-negative (TN) and hormone receptors (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative molecular subtypes, respectively. Regardless of molecular subtypes, metastasis is most commonly evident at the bone. Heterogeneity is a critical pathological feature, leads to therapeutic resistance. BCSCs, biomarkers expression patterns, and mutations contribute to heterogeneity. In this paper, we discuss crucial pathological features of breast cancer metastasis, emphasizing metastasis organotropism and heterogeneity; and mechanisms of breast cancer metastasis, highlighting the pathways of metastasis to the brain. We consider that this paper reinforces future research areas and benefits the general readers, physicians, and researchers to identify potential areas to develop targeted therapies.
尽管在乳腺癌的诊断和治疗方面取得了进展，但转移仍是导致乳腺癌相关死亡的惊人比例的原因。死亡威胁主要可以通过对乳腺癌转移的病理特征多样性和潜在机制缺乏正确理解以及有效的靶向治疗来解释。乳腺癌干细胞（BCSCs）是肿瘤细胞扩散到远处器官的潜在来源。针对BCSCs的治疗可以抑制乳腺癌向转移的进展。肿瘤细胞向骨、肺、肝和脑的扩散通过一个独特的非随机过程发生；称为转移器官嗜性。最近，乳腺癌患者的脑转移被更频繁地检测到，造成了重大的临床负担。与BRCA1和BRCA2相关的乳腺癌发生中枢神经系统转移的倾向明显更高。与BRCA1和BRCA2相关的乳腺癌通常分别倾向于为三阴性（TN）和激素受体（HR）阳性/人表皮生长因子受体2（HER2）阴性分子亚型。无论分子亚型如何，转移最常见于骨。异质性是一个关键的病理特征，导致治疗耐药性。BCSCs、生物标志物表达模式和突变促成了异质性。在本文中，我们讨论了乳腺癌转移的关键病理特征，强调转移器官嗜性和异质性；以及乳腺癌转移的机制，突出了向脑转移的途径。我们认为本文加强了未来的研究领域，并有利于普通读者、医生和研究人员确定开发靶向治疗的潜在领域。
