Skip to main content
Journal cover image

Molecular Subtypes of Breast Cancer: A Review for Breast Radiologists.

Publication ,  Journal Article
Johnson, KS; Conant, EF; Soo, MS
Published in: J Breast Imaging
January 26, 2021

Gene expression profiling has reshaped our understanding of breast cancer by identifying four molecular subtypes: (1) luminal A, (2) luminal B, (3) human epidermal growth factor receptor 2 (HER2)-enriched, and (4) basal-like, which have critical differences in incidence, response to treatment, disease progression, survival, and imaging features. Luminal tumors are most common (60%-70%), characterized by estrogen receptor (ER) expression. Luminal A tumors have the best prognosis of all subtypes, whereas patients with luminal B tumors have significantly shorter overall and disease-free survival. Distinguishing between these tumors is important because luminal B tumors require more aggressive treatment. Both commonly present as irregular masses without associated calcifications at mammography; however, luminal B tumors more commonly demonstrate axillary involvement at diagnosis. HER2-enriched tumors are characterized by overexpression of the HER2 oncogene and low-to-absent ER expression. HER2+ disease carries a poor prognosis, but the development of anti-HER2 therapies has greatly improved outcomes for women with HER2+ breast cancer. HER2+ tumors most commonly present as spiculated masses with pleomorphic calcifications or as calcifications alone. Basal-like cancers (15% of all invasive breast cancers) predominate among "triple negative" cancers, which lack ER, progesterone receptor (PR), and HER2 expression. Basal-like cancers are frequently high-grade, large at diagnosis, with high rates of recurrence. Although imaging commonly reveals irregular masses with ill-defined or spiculated margins, some circumscribed basal-like tumors can be mistaken for benign lesions. Incorporating biomarker data (histologic grade, ER/PR/HER2 status, and multigene assays) into classic anatomic tumor, node, metastasis (TNM) staging can better inform clinical management of this heterogeneous disease.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Breast Imaging

DOI

EISSN

2631-6129

Publication Date

January 26, 2021

Volume

3

Issue

1

Start / End Page

12 / 24

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Johnson, K. S., Conant, E. F., & Soo, M. S. (2021). Molecular Subtypes of Breast Cancer: A Review for Breast Radiologists. J Breast Imaging, 3(1), 12–24. https://doi.org/10.1093/jbi/wbaa110
Johnson, Karen S., Emily F. Conant, and Mary Scott Soo. “Molecular Subtypes of Breast Cancer: A Review for Breast Radiologists.J Breast Imaging 3, no. 1 (January 26, 2021): 12–24. https://doi.org/10.1093/jbi/wbaa110.
Johnson KS, Conant EF, Soo MS. Molecular Subtypes of Breast Cancer: A Review for Breast Radiologists. J Breast Imaging. 2021 Jan 26;3(1):12–24.
Johnson, Karen S., et al. “Molecular Subtypes of Breast Cancer: A Review for Breast Radiologists.J Breast Imaging, vol. 3, no. 1, Jan. 2021, pp. 12–24. Pubmed, doi:10.1093/jbi/wbaa110.
Johnson KS, Conant EF, Soo MS. Molecular Subtypes of Breast Cancer: A Review for Breast Radiologists. J Breast Imaging. 2021 Jan 26;3(1):12–24.
Journal cover image

Published In

J Breast Imaging

DOI

EISSN

2631-6129

Publication Date

January 26, 2021

Volume

3

Issue

1

Start / End Page

12 / 24

Location

United States