Heterogeneity Of Triple-negative Breast Cancer Across Race And Ethnicities, Indian Women At Higher Risk: Should We Be Heading Towards Personalized Medicine? | 38333
Journal of Cancer Science & Therapy
Like us on:
Our Group organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.
Breast cancer is a heterogeneous disease with several subtypes presenting various morphological and molecular features,
and response to therapy. While targeted therapies are available for estrogen receptor positive and HER2-positive breast
tumors, triple-negative breast cancer (TNBC) which are negative for ER, progesterone receptor PR and HER2 receptors lack
suitable targeted therapies. TNBC is one of the most aggressive breast cancer subtypes and poses a clinical challenge as they
lack suitable targeted therapies. Racial disparity has been recognized as a key factor in the incidence and mortality of TNBC
breast cancer. The interaction of race and ethnicity with age, molecular profiles and lifestyles has contributed significantly
to the heterogeneity of TNBC breast cancer. Based on gene expression profiling, cluster analysis identified 6 TNBC subtypes
which included 2 basal-like, an immunomodulatory, a mesenchymal, a mesenchymal cell like, and a luminal androgen receptor
subtype. Each subtype had a unique signaling pathway and responded to targeted therapies. While a majority of breast cancer
patients in the US are postmenopausal, more than 80% of Indian patients are younger than 60 years of age, presenting with
larger tumor size, poor tumor grade, and low rates of hormone-receptor positive status. Recent studies on breast cancer
subtypes across race and ethnicity have indicated that incidence of early onset breast cancer, TNBC in particular is rising at
alarming rates among Indian women. In a study that analyzed molecular subtypes in early onset breast cancer among various
races that included Indian, Chinese, non-Hispanic White (NHW), African American (AA), and Hispanic women, incidence
of TNBC was significantly higher (p=0.0369) with early onset (40 years and younger) in Indian women. This was followed by
AA, Hispanic, NHW and Chinese women. Incidence of HER2 over-expression subtype was also highest among Indian women.
None of the standard risk factors for breast cancer had any significant associations for the early onset breast cancers among
Indian women. Future studies that focus on racial and ethnic differences in genetic, reproductive, lifestyle and environmental
exposures of TNBC pathways will offer unique biomarkers, targeted therapies and clinical trial design leading to personalized
Padma P. Tadi Uppala, PhD, is an Associate Professor in Environmental Toxicology in the School of Public Health at Loma Linda University, and the Program Director for Inland Empire Breast Cancer Research and Outreach Center, USA. Uppala earned her Ph.D. in Biology with a primary focus on environmental carcinogenesis from Loma Linda University in 1991 and obtained postdoctoral training in Environmental Toxicology at the University of California, Riverside, USA. She earned her MSc. in Parasitology from Kakatiya University, Warangal, India and B.Ed. from Osmania University, Hyderabad, India. She has authored several scientific publications in the area of pesticides and biomarkers for breast cancer. teaching Medical Biochemistry to D.O. students. He is interested in studying the effect of steroid hormones on cancer using mouse and human melanoma cell lines as model systems.