Genotyping of breast cancer

  Breast cancer is a large collection of diseases consisting of multiple heterogeneous lesions. Although they are all named breast cancer, the abnormal molecules, cancer cell composition and clinical regression of these lesions are different, thus making the tumor classification of breast cancer even more special.  Based on the results of genomic analysis and the biological characteristics of breast cancer, breast cancers are classified into: (1) Luminal A (luminal A type); (2) Luminal B (luminal B type); (3) HER-2 overexpressed; (4) Basal-like basal-like; and (5) Normal-like normal cell-like.  Luminal A type ER+PR+Her-2-; Luminal B type ER+PR+Her-2+ (also called triple positive type). These two types account for 2/3 of breast cancers and are more common in patients aged 50 years. type A mostly expresses ER, PS2, Bcl-2 and has a better prognosis and is sensitive to endocrine therapy. type B is positive for ER+, PR+, Her-2+ and TAM is not effective when using endocrine therapy and should be used for Als with better results.  HER-2(+) type is ER-PR- and Her-2 positive. This type has poor histological grading, Ki67 proliferation and epidermal growth factor receptor positivity, poor prognosis, basically ineffective endocrine therapy, short disease-free survival and overall survival, but good chemotherapy and targeted therapy, Her-2 abnormalities are: Her-2 gene mutation, Her-2 phosphorylation status, abnormal signaling pathways.  Basal-like type: ER-;PR-;Her-2-. Equivalent to triple-negative breast cancer. This type of breast cancer is highly expressed in Ck5/6, or CK17, and Her-1, and has poor histological differentiation and is associated with mutations in P53. It occurs in women under 40 years of age and accounts for about 15% of all breast cancers, with a 5-year survival rate of <15%. Therefore, chemotherapy should be actively used in the early stage, with reasonable and adequate amount of chemotherapy drugs, using strong chemotherapy drugs with high efficacy and controllable side effects, and in the late stage, single drug or combination chemotherapy should be selected and sequential treatment should be used, not to give up lightly in order to achieve maximum tumor killing.  Normal-like type: high expression of genes in adipose tissue and non-epithelial cells, low expression of luminal epithelial genes such as P1K 3R1, KR1C1. Since the gene expression of breast cancer varies widely. Therefore, preoperative staging and staging is particularly important. Careful selection of treatment plan should avoid over-treatment and prevent under-dosing. Parker, an American scholar, constructed a 50-gene based prediction method for the above five breast cancer molecular types based on data from 189 breast cancer specimens and 29 normal breast samples. The results were distributed across subtypes, both ER and Her-2 positive and negative, indicating that ER/Her-2 status alone could not accurately distinguish between subtypes, but there were still significant differences in recurrence-free survival between subtypes.