New Findings on Breast Cancer Stem Cells: A Review

Abstract

Since the introduction of the "cancer stem cell" theory, significant developments have been made in the understanding of cancer and the heterogenic structure of tumors. In 2003, with the isolation of cancer stem cells from the first solid tumor, breast cancer, and recognition of the tumorigenicity of these cells, this theory suggested that the main reason for therapy failure might be the presence of cancer stem cells. This review article describes breast cancer stem cell origin, the related cellular and molecular characteristics, signaling pathways, and therapy resistance mechanisms. The databases PubMed, SCOPUS, and Embase were explored, and articles published on these topics between 1992 and 2015 were investigated. It appears that this small subpopulation of cells, with the capacity for self-renewal and a high proliferation rate, originate from normal stem cells, are identified by specific markers such as CD44(+)/CD24(-/low), and enhance a tumor's capacity for metastasis, invasion, and therapy resistance. Cancer stem cell characteristics depend on their interactions with their microenvironment as well as on the inducing factors and elements. Although uncertainties about breast cancer stem cells exist, many of researchers believe that cancer stem cells should be considered as possible therapeutic targets.

Keywords: Biological markers; Breast neoplasms; Neoplastic stem cells.

Figure 1. The most possible mechanisms of therapy resistance in breast cancer stem cells.

MDR1=multidrug resistance protein 1; P-gp =glycoprotein P; BCRP=breast cancer resistance protein; ABC=ATP-binding cassette; ALDH1=aldehyde dehydrogenase 1; ROS=reactive oxygen species.