От определения HER2-положительного рака молочной железы к характеристике трижды позитивного рака: морфологические и клинические аспекты с точки зрения морфолога

Подтип рака молочной железы с коэкспрессией рецепторов эстрогена (ER), прогестерона (PR) и амплификацией HER2, названный трижды позитивным, имеет особую клиническую значимость.

Биологическая особенность данного подтипа заключается в перекрестном взаимодействии сигнальных путей ER и HER 2, что приводит к развитию резистентности к терапии через активацию каскадов Ras / M ek / MAP K и PI 3K / A KT и проявляется в уникальном клиническом течении. Трижды позитивный рак молочной железы характеризуется неблагоприятным прогнозом и агрессивным клиническим течением, однако достижения лекарственной терапии последних десятилетий изменили эту парадигму. Поэтому точная оценка статусов HER2 и гормональных рецепторов играет решающую роль в эффективности лечения трижды позитивных карцином.

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