Breast cancer intrinsic subtype classification, clinical use and future trends.

TLDR

Breast cancer comprises multiple subtypes with distinct morphologies and clinical implications, and microarray‑based intrinsic subtyping using multigene classifiers has revealed overlapping yet distinct gene panels, prompting the emergence of novel subtypes and driving a debate between further refinement and convergence. This review aims to explore and summarize the existing intrinsic subtypes, associated patient clinical features and management, commercial signature panels, and diverse data used for tumor classification. The authors conduct a comprehensive literature synthesis of intrinsic subtypes, clinical characteristics, therapeutic approaches, commercial panels, and classification information. The review clarifies breast cancer intrinsic classification, outlines its current clinical application status, and highlights future trends.

Abstract

Breast cancer is composed of multiple subtypes with distinct morphologies and clinical implications. The advent of microarrays has led to a new paradigm in deciphering breast cancer heterogeneity, based on which the intrinsic subtyping system using prognostic multigene classifiers was developed. Subtypes identified using different gene panels, though overlap to a great extent, do not completely converge, and the avail of new information and perspectives has led to the emergence of novel subtypes, which complicate our understanding towards breast tumor heterogeneity. This review explores and summarizes the existing intrinsic subtypes, patient clinical features and management, commercial signature panels, as well as various information used for tumor classification. Two trends are pointed out in the end on breast cancer subtyping, i.e., either diverging to more refined groups or converging to the major subtypes. This review improves our understandings towards breast cancer intrinsic classification, current status on clinical application, and future trends.