Breast cancer complexity: implications of intratumoral heterogeneity in clinical management

摘要: Generation of intratumoral phenotypic and genetic heterogeneity has been attributed to clonal evolution cancer stem cells that together give rise a tumor with complex ecosystems. Each ecosystem contains various cell subpopulations stromal entities, which, depending upon their composition, can influence survival, therapy responses, global growth the tumor. Despite recent advances in breast management, disease not completely eradicated as tumors recur despite initial response treatment. In this review, using data from clinically relevant models, we show fates cells/progenitor individual ecosystems comprising are predetermined follow limited (unipotent) and/or unlimited (multipotent) path differentiation which create conditions for active generation maintenance heterogeneity. The resultant dynamic systems respond differently treatments, thus disrupting delicate stability maintained heterogeneous This raises question whether it is better then preserve by preventing takeover otherwise dormant following therapy. ultimate strategy personalized would require serial assessments patient’s biomarker validation during entire course treatment combined three-dimensional mapping architecture landscape.