Breast cancer: an up‐to‐date review and future perspectives

Abstract

Breast cancer is the most common cancer worldwide. The occurrence of breast cancer is associated with many risk factors, including genetic and hereditary predisposition. Breast cancers are highly heterogeneous. Treatment strategies for breast cancer vary by molecular features, including activation of human epidermal growth factor receptor 2 (HER2), hormonal receptors (estrogen receptor [ER] and progesterone receptor [PR]), gene mutations (e.g., mutations of breast cancer 1/2 [BRCA1/2] and phosphatidylinositol‐4,5‐bisphosphate 3‐kinase catalytic subunit alpha [PIK3CA]) and markers of the immune microenvironment (e.g., tumor‐infiltrating lymphocyte [TIL] and programmed death‐ligand 1 [PD‐L1]). Early‐stage breast cancer is considered curable, for which local‐regional therapies (surgery and radiotherapy) are the cornerstone, with systemic therapy given before or after surgery when necessary. Preoperative or neoadjuvant therapy, including targeted drugs or immune checkpoint inhibitors, has become the standard of care for most early‐stage HER2‐positive and triple‐negative breast cancer, followed by risk‐adapted post‐surgical strategies. For ER‐positive early breast cancer, endocrine therapy for 5‐10 years is essential. Advanced breast cancer with distant metastases is currently considered incurable. Systemic therapies in this setting include endocrine therapy with targeted agents, such as CDK4/6 inhibitors and phosphoinositide 3‐kinase (PI3K) inhibitors for hormone receptor‐positive disease, anti‐HER2 targeted therapy for HER2‐positive disease, poly(ADP‐ribose) polymerase inhibitors for BRCA1/2 mutation carriers and immunotherapy currently for part of triple‐negative disease. Innovation technologies of precision medicine may guide individualized treatment escalation or de‐escalation in the future. In this review, we summarized the latest scientific information and discussed the future perspectives on breast cancer.

Optimal Assessment of Metastatic Breast Carcinoma: The Value of Cytopathology Combined with Molecular Analysis

“…Therapeutically relevant genomic biomarkers to be assessed concerning immunochemistry classification include: germline BRCA1/2 mutations in HER2-negative MBC; somatic BRCA mutations in HER2-low MBC; PIK3CA, germline BRCA1/2 mutations, PALB2 mutations (optional), and ESR1 (optional) in ER positive, HER2-negative MBC; PD-L1, germline BRCA1/2 mutations, and PALB2 mutations (optional) in TNBC tumors; and in all patients MSI, TMB, and NTRK only if corresponding therapies are available [5,49].…”

“…In Table 2, a summary of the genomic changes in MBC associated with the respective breast cancer subtypes, detection tests, prevalence, rating scales, and targeted therapies [5,12,37,49,52,53].…”

An enzyme-powered microRNA discriminator for the subtype-specific diagnosis of breast cancer

“…As a burden to healthcare systems around the globe, breast cancer is now the most frequent malignant tumour-related disease diagnosed worldwide, a condition that seriously threatens the lives of people around the globe. [1][2][3] In recent decades, breast cancer mortality has signicantly declined in line with advances made in therapeutics, but metastatic breast cancer remains a leading cause of cancer-related death. 4,5 As the molecular levels alter in different breast tumours, the heterogeneity of the malignancy can be categorised into several subtypes based on the tumour expressions of the oestrogen receptor, progesterone receptor (PR), and the human epidermal growth factor receptor-2 (HER-2).…”

Design, synthesis and anti-breast cancer properties of butyric ester tethered dihydroartemisinin-isatin hybrids

“…Breast cancer, originates as a result of aberrant cell division in the breast, remains the most prevalent malignancy and the leading cause of cancer deaths [ 1 , 2 ]. Currently, standard treatment approaches for breast cancers are surgery accompanied by chemotherapy or radiotherapy, and around 70% of patients with early-stage are curable [ 3 , 4 ].…”