Resumen
Objetivo: Correlacionar la influencia de estos subtipos en el desarrollo y pronóstico del cáncer de mama, abordando las características histopatológicas y evolutivas de cada clasificación, relacionando así caracterización de la expresión génica por medio de métodos de cDNA microarray e inmuno-histoquímica, además del desarrollo de firmas pronósticas y predictivas. Revisión bibliográfica: El cáncer de mama, como enfermedad heterogénea, se considera una patología compleja y multifacética que engloba una variedad de factores moleculares que permiten la expresión de diferentes características clínicas, morfológicas y comportamentales. Se divide en subtipos moleculares mediante análisis genético, a saber: Luminal A, Luminal B, ERBB2/HER2 amplificado, Triple Negativo y Claudin-low. La inmunohistoquímica detecta la presencia de biomarcadores como el receptor de progesterona, el receptor de estrógeno, ERBB2/HER2 y Ki-67, contribuyendo a la evaluación de riesgos, el diagnóstico diferencial y el pronóstico. Además, es posible establecer el tratamiento sistémico ideal para cada paciente, así como presumir la respuesta terapéutica a una terapia determinada. Consideraciones finales: Las características biológicas y moleculares de estos subtipos moleculares, con patrones morfológicos e inmunofenotípicos distintos, permiten una mejor comprensión de los métodos de formación, mantenimiento y progresión de los tumores de carcinoma de mama, con el fin de desarrollar un enfoque terapéutico individualizado para cada pronóstico.
Referencias
BAHRIN NWS, et al. Exploring the effectiveness of molecular subtypes, biomarkers, and genetic variations as first-line treatment predictors in Asian breast cancer patients: a systematic review and meta-analysis. Systematic Reviews, 2024; 13(1):100.
BENITEZ FUENTES JD, et al. Global Stage Distribution of Breast Cancer at Diagnosis: A Systematic Review and Meta-Analysis. JAMA Oncology, 2024; 10 (1): 71.
BRASIL. Ministério da Saúde, Instituto Nacional de Câncer (INCA). Controle do câncer de mama no Brasil: dados e números. 2024. Disponível em: https://www.inca.gov.br/publicacoes/livros/controle-do-cancer-de-mama-no-brasil-dados-e-numeros-2024. Acessado em: 26/02/2025
CHAUDHARY LN, et al. Triple-Negative Breast Cancer. Surgical Oncology Clinics of North America, 2018; 27(1): 141–153.
CHENG T, et al. CDKN2A-mediated molecular subtypes characterize the hallmarks of tumor microenvironment and guide precision medicine in triple-negative breast cancer. Frontiers in Immunology, 2022; 13:970950.
DING YC, et al. Molecular subtypes of triple-negative breast cancer in women of different race and ethnicity. Oncotarget, 2019; 10(2): 198–208.
FAHAD ULLAH M. Breast Cancer: Current Perspectives on the Disease Status. In: AHMAD, A. (Ed.). Breast Cancer Metastasis and Drug Resistance. Cham: Springer International Publishing, 2019. v. 1152p. 51–64.
FERLAY J, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. International Journal of Cancer, 2019; 144(8): 1941–1953.
FRAGOMENI SM, et al. Molecular Subtypes and Local-Regional Control of Breast Cancer. Surgical Oncology Clinics of North America, 2018; 27(1): 95–120.
JÁCOME LGR, et al. Perfil imuno-histoquímico e variáveis clinicopatológicas do câncer de mama em Roraima. Brazilian Journal of Health Review, 2024; 7(9): e75270.
KALININA TS, et al. Association between Lymph Node Status and Expression Levels of Androgen Receptor, miR-185, miR-205, and miR-21 in Breast Cancer Subtypes. International Journal of Breast Cancer, 2020; 2020: 1–7.
KARIM AM, et al. Triple-negative breast cancer: epidemiology, molecular mechanisms, and modern vaccine-based treatment strategies. Biochemical Pharmacology, 2023; 212: 115545.
KASHYAP D, et al. [Retracted] Global Increase in Breast Cancer Incidence: Risk Factors and Preventive Measures. BioMed Research International, 2022; 2022(1): e9605439.
KATSURA C, et al. Breast cancer: presentation, investigation and management. British Journal of Hospital Medicine, 2022; 83(2): 1–7.
LIN K, et al. The Breast Cancer Protooncogenes HER2, BRCA1 and BRCA2 and Their Regulation by the iNOS/NOS2 Axis. Antioxidants, 2022; 11(6): 1195.
LOPEZ-GONZALEZ L, et al. Exploring Biomarkers in Breast Cancer: Hallmarks of Diagnosis, Treatment, and Follow-Up in Clinical Practice. Medicina, 2024; 60 (1): 168.
ŁUKASIEWICZ S, et al. Breast Cancer—Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies—An Updated Review. Cancers, 2021; 13(17): 4287
MATHUR P, et al. Cancer Statistics, 2020: Report from National Cancer Registry Programme, India. JCO Global Oncology, 2020; 6: 1063–1075.
NOLAN E, et al. Deciphering breast cancer: from biology to the clinic. Cell, 2023; 186(8): 1708–1728.
PAN C, et al. Research progress of Claudin-low breast cancer. Frontiers in Oncology, 2023; 13: 1226118.
PROVENZANO E, et al. Molecular Classification of Breast Cancer. PET Clinics, 2018; 13(3): 325–338.
QATTAN A, et al. Clinical Identification of Dysregulated Circulating microRNAs and Their Implication in Drug Response in Triple Negative Breast Cancer (TNBC) by Target Gene Network and Meta-Analysis. Genes, 2021; 12(4): 549.
RAKHA EA, et al. Assessment of Predictive Biomarkers in Breast Cancer: Challenges and Updates. Pathobiology, 2022; 89(5): 263–277.
ROY M, et al. Molecular Classification of Breast Cancer. PET Clinics, 2023; 18(4): 441–458. 2023.
SONG Y, et al. Identification of potential immunotherapy biomarkers for breast cancer by bioinformatics analysis. Bioscience Reports, 2022; 42(2): BSR20212035.
SOUZA KCB, et al. Identification of Cell-Free Circulating MicroRNAs for the Detection of Early Breast Cancer and Molecular Subtyping. Journal of Oncology, 2019; 2019: 1–11.
TURNER KM, et al. Heterogeneity within molecular subtypes of breast cancer. American Journal of Physiology-Cell Physiology, 2021; 321(2): C343–C354.
