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Abstract

Breast Cancer Intra-Tumor Heterogeneity: One Tumor, Different Entities

VOLUME 69 - NUMBER 2 / March - April (In-depth Reviews)  doi: 10.24875/RIC.17002177

José Esparza-López, Biochemistry Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Elizabeth Escobar-Arriaga, Oncology Center, Hospital Ángeles del Pedregal, Mexico City, Mexico
Santos Soto-Germes, Integral Oncology Center, Servicio de Tumores Mamarios, Hospital Médica Sur, Mexico City, Mexico
María de J. Ibarra-Sánchez, Biochemistry Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

In recent years, it has become evident that intra-tumor heterogeneity of breast cancer is a big challenge for the diagnosis, treatment, and clinical course of tumor-bearing patients. The advances in molecular biology and other technologies have led to the knowledge that a breast cancer tumor is comprised of multiple cellular entities. Here we review the two theories that have been described, trying to explain the origin of intra-tumor heterogeneity: clonal evolution and cancer stem cells. The first one considers that a single cell gives rise to many subpopulations through the accumulation of multiple aberrations, while the cancer stem cells theory foresees a hierarchical tumor evolution where only a few cells with self-renewal capacity give rise to different subpopulations. We also analyze the genetic, epigenetic, and microenvironment contributions to breast cancer intra-tumor heterogeneity. Finally, the clinical and therapeutic impact of intra-tumor heterogeneity on the outcome of breast cancer patients is discussed.

Keywords: Breast cancer. Cancer stem cell. Clonal evolution. Intra-tumor heterogeneity.

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