Song Bowen, Singh Harnoor
Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
Healthcare (Basel). 2024 Dec 9;12(23):2483. doi: 10.3390/healthcare12232483.
BACKGROUND/OBJECTIVES: Breast cancer is one of the most common malignancies in women, with rare subtypes presenting unique clinical challenges. This review provides a comprehensive analysis of rare breast cancers, including both epithelial and non-epithelial subtypes, and explores their epidemiology, pathology, prognosis, and treatment approaches.
A systematic review was conducted focusing on recent advancements in the treatment of rare breast cancer subtypes. Articles were selected based on criteria emphasizing studies from the past five years, with older foundational studies included where necessary. The analysis incorporated molecular profiling, clinical trials, and advancements in targeted and immunotherapies, where possible.
Rare epithelial subtypes, such as tubular, mucinous, and medullary carcinomas, demonstrate distinct clinical and pathological features, with generally favorable prognoses compared to invasive ductal carcinoma (IDC). Non-epithelial cancers, including sarcomas and primary breast lymphomas, require individualized treatment due to aggressive behavior and poor prognosis in certain cases. Recent advancements in targeted therapies (e.g., HER2 inhibitors, PI3K inhibitors, and PARP inhibitors) and immunotherapies (e.g., PD-1 inhibitors) have shown promise in improving outcomes for specific molecularly characterized subtypes.
While the management of common breast cancers has become increasingly sophisticated, rare subtypes continue to pose challenges due to limited research and small patient populations. Advances in molecular profiling and next-generation sequencing are pivotal in identifying actionable mutations and expanding personalized treatment options. Future research should focus on clinical trials and collaborative efforts to refine treatment strategies and improve outcomes for these rare subtypes.
背景/目的:乳腺癌是女性最常见的恶性肿瘤之一,罕见亚型带来独特的临床挑战。本综述对罕见乳腺癌进行了全面分析,包括上皮和非上皮亚型,并探讨了它们的流行病学、病理学、预后和治疗方法。
进行了一项系统综述,重点关注罕见乳腺癌亚型治疗的最新进展。根据强调过去五年研究的标准选择文章,必要时纳入较旧的基础研究。分析尽可能纳入分子谱分析、临床试验以及靶向和免疫治疗的进展。
罕见上皮亚型,如管状癌、黏液癌和髓样癌,表现出独特的临床和病理特征,与浸润性导管癌(IDC)相比,预后通常较好。非上皮性癌症,包括肉瘤和原发性乳腺淋巴瘤,由于某些情况下侵袭性强且预后差,需要个体化治疗。靶向治疗(如HER2抑制剂、PI3K抑制剂和PARP抑制剂)和免疫治疗(如PD-1抑制剂)的最新进展已显示出有望改善特定分子特征亚型的治疗结果。
虽然常见乳腺癌的管理已日益复杂,但由于研究有限和患者群体较小,罕见亚型仍然带来挑战。分子谱分析和下一代测序的进展对于识别可操作的突变和扩大个性化治疗选择至关重要。未来的研究应侧重于临床试验和合作努力,以完善治疗策略并改善这些罕见亚型的治疗结果。