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Molecular intrinsic versus clinical subtyping in breast cancer: A comprehensive review
Clinical Genetics ( IF 3.5 ) Pub Date : 2020-12-19 , DOI: 10.1111/cge.13900
Agata Szymiczek 1 , Amna Lone 1 , Mohammad R Akbari 1, 2, 3
Affiliation  

Breast cancer is a heterogeneous disease manifesting diversity at the molecular, histological and clinical level. The development of breast cancer classification was centered on informing clinical decisions. The current approach to the classification of breast cancer, which categorizes this disease into clinical subtypes based on the detection of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and proliferation marker Ki67, is not ideal. This is manifested as a heterogeneity of therapeutic responses and outcomes within the clinical subtypes. The newer classification model, based on gene expression profiling (intrinsic subtyping) informs about transcriptional responses downstream from IHC single markers, revealing deeper appreciation for the disease heterogeneity and capturing tumor biology in a more comprehensive way than an expression of a single protein or gene alone. While accumulating evidences suggest that intrinsic subtypes provide clinically relevant information beyond clinical surrogates, it is imperative to establish whether the current conventional immunohistochemistry‐based clinical subtyping approach could be improved by gene expression profiling and if this approach has a potential to translate into clinical practice.

中文翻译:

乳腺癌的分子内在与临床亚型:综合评价

乳腺癌是一种异质性疾病,在分子、组织学和临床水平上表现出多样性。乳腺癌分类的发展集中在为临床决策提供信息。目前的乳腺癌分类方法,即根据雌激素受体、孕激素受体、人表皮生长因子受体2和增殖标志物Ki67的检测将该疾病分为临床亚型,并不理想。这表现为临床亚型内治疗反应和结果的异质性。更新的分类模型,基于基因表达谱(内在亚型),告知 IHC 单个标记下游的转录反应,揭示了对疾病异质性的更深入理解,并以比单独表达单个蛋白质或基因更全面的方式捕捉肿瘤生物学。虽然越来越多的证据表明内在亚型提供了临床替代之外的临床相关信息,但必须确定当前基于免疫组织化学的常规临床亚型方法是否可以通过基因表达谱进行改进,以及这种方法是否有可能转化为临床实践。
更新日期:2020-12-19
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