Lani
07-19-2006, 11:10 AM
OPEN ACCESS: EDITORIAL: Breast Cancer Heterogeneity: A Mixture of At Least Two Main Types? [Journal of the National Cancer Institute; Subscribe; Sample]
In conclusion, the mouse model system of Asselin-Labat et al. appears to support a large body of emerging—as well as established molecular, epidemiologic, and clinical—evidence that is consistent with a stem cell or mixture breast cancer model, resulting in at least two main breast cancer types according to epithelial cellular origin and/or hormone responsiveness. Clinicians, in fact, have long suspected two main breast cancer types, which are mixed within the general population. The first breast cancer is early onset with peak incidence near age 50 years and hormone dependent. The second breast cancer is late onset with peak incidence near age 70 years and largely hormone independent.
These data provide opportunity for reflection and change. At a minimum, breast cancer can no longer be viewed as one biologic entity. The concept of a stem cell or mixture model could form the basis for revised conceptual frameworks. For if breast cancer overall consists of a mixture of at least two main types, we need a stratified rather than a unified approach for breast cancer research, prevention, and treatment. For example, breast cancer research must consider subgroup as well as main effects. Breast cancer prevention must focus on tumor-initiating or gatekeeper events. Breast cancer therapy must target the undifferentiated, self-renewing, and cancer-initiating stem cell population.
I am sure all of you are asking--where do I fit in here? As usualy there are probably two main types and her2+ whether + or - are like square pegs not fitting in round holes. Just as they should not assume breast cancer is one disease, they should not assume it is two diseases. It comes in multiple varieties and in fact any one person's cancer is probably unique. It seems her2+er- breast cancer has its own subtype according to multigene array data but her2+er+ are among several types classified in luminal B group according to mga data. I am sure with time her2+er+ will probably be better subclassified and may have several group within itself as well.
It seems the NCI believes in the stem cell theory of breast cancer...
It seems a shame politics can put the lives of so many waiting for medical breakthroughs at risk!
In conclusion, the mouse model system of Asselin-Labat et al. appears to support a large body of emerging—as well as established molecular, epidemiologic, and clinical—evidence that is consistent with a stem cell or mixture breast cancer model, resulting in at least two main breast cancer types according to epithelial cellular origin and/or hormone responsiveness. Clinicians, in fact, have long suspected two main breast cancer types, which are mixed within the general population. The first breast cancer is early onset with peak incidence near age 50 years and hormone dependent. The second breast cancer is late onset with peak incidence near age 70 years and largely hormone independent.
These data provide opportunity for reflection and change. At a minimum, breast cancer can no longer be viewed as one biologic entity. The concept of a stem cell or mixture model could form the basis for revised conceptual frameworks. For if breast cancer overall consists of a mixture of at least two main types, we need a stratified rather than a unified approach for breast cancer research, prevention, and treatment. For example, breast cancer research must consider subgroup as well as main effects. Breast cancer prevention must focus on tumor-initiating or gatekeeper events. Breast cancer therapy must target the undifferentiated, self-renewing, and cancer-initiating stem cell population.
I am sure all of you are asking--where do I fit in here? As usualy there are probably two main types and her2+ whether + or - are like square pegs not fitting in round holes. Just as they should not assume breast cancer is one disease, they should not assume it is two diseases. It comes in multiple varieties and in fact any one person's cancer is probably unique. It seems her2+er- breast cancer has its own subtype according to multigene array data but her2+er+ are among several types classified in luminal B group according to mga data. I am sure with time her2+er+ will probably be better subclassified and may have several group within itself as well.
It seems the NCI believes in the stem cell theory of breast cancer...
It seems a shame politics can put the lives of so many waiting for medical breakthroughs at risk!