PDF(Pubmed)
Abstract：
The onset of pregnancy marks the start of offspring development, and represents the key physiological event that induces re-organization and specialization of breast tissue. Such drastic tissue remodeling has also been linked to epithelial cell transformation and the establishment of breast cancer (BC). While patient outcomes for BC overall continue to improve across subtypes, prognosis remains dismal for patients with gestational breast cancer (GBC) and post-partum breast cancer (PPBC), as pregnancy and lactation pose additional complications and barriers to several gold standard clinical approaches. Moreover, delayed diagnosis and treatment, coupled with the aggressive time-scale in which GBC metastasizes, inevitably contributes to the higher incidence of disease recurrence and patient mortality. Therefore, there is an urgent and evident need to better understand the factors contributing to the establishment and spreading of BC during pregnancy. In this review, we provide a literature-based overview of the diagnostics and treatments available to patients with BC more broadly, and highlight the treatment deficit patients face due to gestational status. Further, we review the current understanding of the molecular and cellular mechanisms driving GBC, and discuss recent advances in model systems that may support the identification of targetable approaches to block BC development and dissemination during pregnancy. Our goal is to provide an updated perspective on GBC, and to inform critical areas needing further exploration to improve disease outcome.
摘要：
怀孕的开始标志着后代发育的开始，并代表诱导乳腺组织重新组织和特化的关键生理事件。这种剧烈的组织重塑也与上皮细胞转化和乳腺癌（BC）的建立有关。虽然不同亚型的患者BC总体结果继续改善，妊娠乳腺癌（GBC）和产后乳腺癌（PPBC）患者的预后仍然不佳，因为妊娠和哺乳期会给几种金标准临床方法带来额外的并发症和障碍。此外，延迟诊断和治疗，再加上GBC转移的激进时间尺度，不可避免地导致了较高的疾病复发率和患者死亡率。因此,迫切需要更好地了解导致怀孕期间BC建立和传播的因素。在这次审查中,我们提供了更广泛的BC患者可用的诊断和治疗的基于文献的概述，并强调患者由于妊娠状态而面临的治疗缺陷。Further,我们回顾了目前对驱动GBC的分子和细胞机制的理解，并讨论模型系统的最新进展，这些模型系统可能支持识别在怀孕期间阻断BC发展和传播的有针对性的方法。我们的目标是提供有关GBC的最新观点，并告知需要进一步探索以改善疾病预后的关键领域。
