Abstract
The progression of breast cancer and its association with clinical outcome and treatment remain largely unexplored. Accumulating data has highlighted the interaction between cells of the immune system and the tumor microenvironment in cancer progression, and although studies have identified multiple facets of cancer progression within the development of the tumor microenvironment (TME) and its constituents, there is lack of research into the associations between breast cancer subtype and staging. Current literature has provided insight into the cells and pathways associated with breast cancer progression through expression analysis. However, there is lack of co-expression studies between immune pathways and cells of the TME that form pro-tumorigenic relationships contributing to immune-evasion. We focus on the immune checkpoint and TME elements that influence cancer progression, particularly studies in molecular subtypes of breast cancer.
Highlights
Breast carcinoma remains a complex heterogeneous disorder, being the most frequent malignant disease in women worldwide, leading to premature death in women in developed countries [1]
These studies show the importance of cancer-associated fibroblasts (CAF) in cancer progression and their ability to alter the normal function of fibroblasts and their anti-tumorigenic abilities
Siglec-9 interacts with sialic acids on cancer cells leading to immune suppression [152]
Summary
Breast carcinoma remains a complex heterogeneous disorder, being the most frequent malignant disease in women worldwide, leading to premature death in women in developed countries [1]. The main biological markers utilized in the diagnosis and treatment of breast cancer include the overexpression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) Based on these clinically used markers, 5 major molecular intrinsic subtypes of breast cancer have been identified: (i) luminal A (histological phenotype: ER+, PR+, HER2−, Ki67−), (ii) luminal B (iv) basal-like subtype (ER−, PR−, HER2−, triple negative; associated with poor prognosis and early onset of metastasis) and (v) claudin-low tumor subtype which is commonly classified as basal-like (or normal breast-like) [8,9,10,11] In addition to these established subtypes, breast cancer staging refers to the extent of disease and is a critical factor in the prognostic outcomes of the patients as well as for oncologists in making treatment decisions. We focus on immune cells within the TME and immune-checkpoints associated with breast cancer progression
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