THE CLONAL EVOLUTION OF BREAST CANCER: CURRENT PERSPECTIVES OF A LONG-STANDING THEORY
(LITERATURE REVIEW) 

Brosalov Vladimir Mikhaylovich, Assistant, sub-department of human physiology, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: vbrosalov@mail.ru
Sudapina Alina Rashidovna, Student, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: sudapinaa@mail.ru
Mikulyak Nadezhda Ivanovna, Doctor of medical sciences, associate professor, head of the sub-department of human physiology, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: normphys@mail.ru 

616.006.66 

10.21685/2072-3032-2020-2-11 

Breast cancer is extremely heterogeneous in its clinical, morphological and molecular genetic characteristics. Despite early detection and increased knowledge of its biology and chemoresistance, metastatic breast cancer is a largely incurable disease. The constantly increasing trend in the development of this malignant neoplasm leads to the need to search for new methods of diagnosis, treatment and prognosis. One of the main reasons complicating treatment is the heterogeneity of the tumor. It is observed in individual patients (inter-tumor) and in each individual tumor (intratumor). The review presents modern studies demonstrating the concept of clonal selection as a key link of intra-tumor heterogeneity. In the process of evolution, the subclones of tumor cells are arbitrarily subjected to various mutations or epigenetic changes that lead to the transformation of molecular and biological characteristics, which is a leading factor for the adaptation of tumor cells (including the damaging effect of chemotherapy drugs) and further tumor progression. Thus, metastasis and the formation of resistance to therapy (the main causes of adverse outcomes in patients with malignant tumors) may be due to the process of clonal evolution. The study of this concept, its mechanisms and influence on the clinical course is one of the promising methods in Oncology. 

clonal evolution, intra-tumor heterogeneity, breast cancer 

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