Stem cells 2013 July-4


Cancer stem cell markers are associated with adverse biomarker profiles and molecular subtypes of breast cancer.

Breast Cancer Res Treat. 2012 Nov;136(2):407-17.

Tsang JY, Huang YH, Luo MH, Ni YB, Chan SK, Lui PC, Yu AM, Tan PH, Tse GM.

Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong.


Cumulative evidence has demonstrated the presence of cancer stem cells (CSC) in breast cancer and its putative role in cancer progression. Nonetheless, the clinical significance of CSC in breast cancer remains elusive. The underlying reasons could be due to the heterogeneity of breast cancer subtypes as well as different markers used to define breast CSC. In this study, three widely used markers (aldehyde dehydrogenase (ALDH)1+ and CD24-CD44+) were used to define two populations of CSC in a large cohort of breast cancers. The expressions of these markers were correlated with different clinicopathological features and the molecular subtypes. ALDH1+ breast cancers were associated with basal-like and HER2-overexpressing subtypes and the characteristics histologic features were related to these two subtypes. On the other hand, CD24-CD44+ breast cancers were associated positively with the presence of extensive in situ component, the absence of lymph node involvement, and basal markers, but negatively with HER2. CD24-CD44+ breast cancers were also positively associated with luminal B cancers. As the expression of CSC markers varied among different molecular subtypes and different clinicopathological features, it appeared that each CSC population could have distinct clinical values in different subgroups of breast cancers. For improved prognostication with CSC, combining the analysis of CSC markers would be required. Within the luminal cancers, CSC appeared to identify cancers with poor outcome. The presence of CSC populations was associated with ER-PR+ cancers and tumors expressing basal markers. Basal marker expression can complement with CSC for improved indicator for poor prognosis in luminal breast cancers. For the first time, the possible contribution of CSC to these aggressive luminal cancers was demonstrated. The association of basal features and CSC in luminal cancers also raised the possibility that luminal cancer cells may acquire basal phenotype and CSC properties together during their progression.

PMID: 23053657


Supplementary information:

With the growing evidence that the presence of cancer stem cells play a central role in tumoriogenesis and treatment resistance in breast cancer, the identification and characterisation of this population is becoming one of the main areas in breast cancer research. It could lead to development of directed therapies against these cells, hence more effective treatment. Nonetheless, the clinical significance of cancer stem cell in breast cancers remains elusive. The reasons behind could be different markers proposed for cancer stem cell identification and the heterogeneity in breast cancer. Our findings revealed that different cancer stem cell populations may be existed in different breast cancer subtypes. Further, it indicated that combined analysis of cancer stem cell markers may be required for its clinical application. 

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