Breast cancer heterogeneity and its implication in personalized precision therapy

Abstract

Breast cancer heterogeneity determines cancer progression, treatment effects, and prognosis. However, the precise mechanism for this heterogeneity remains unknown owing to its complexity. Here, we summarize the origins of breast cancer heterogeneity and its influence on disease progression, recurrence, and therapeutic resistance. We review the possible mechanisms of heterogeneity and the research methods used to analyze it. We also highlight the importance of cell interactions for the origins of breast cancer heterogeneity, which can be further categorized into cooperative and competitive interactions. Finally, we provide new insights into precise individual treatments based on heterogeneity.

Keywords: Breast cancer; Cell competition; Cell interaction; Heterogeneity; Precision therapy.

Fig. 1

Inter- and intratumor heterogeneity of breast cancer. A Intertumoral heterogeneity: a Variation in different breast cancer subtypes among different patients; b Variation in different breast cancer subtypes in patients with primary breast cancer and its metastasis in the same patient. B Intratumor heterogeneity: variation in different cell types within a tumor

Fig. 2

Schematic of breast cancer microenvironment. Breast cancer cells infiltrate tissues and interact with various cell types

Fig. 3

Interactions among diverse cells in the breast cancer microenvironment. The breast cancer microenvironment includes fibroblasts, adipocytes, immune cells, epithelial cells, and breast cancer cells. The interactions can be promoted (cooperative) or inhibited (competitive), leading to the generation of two cell types. The two types of cells undergo different fates, one more competitive, with more diverse and intense biological behavior, and the other gradually dying off