Abstract
Breast cancer is a heterogeneous disease that can be divided into different molecular subtypes, each with different clinical and pathological characteristics. HER2-positive breast cancer is a subtype characterized by overexpression of the HER2 protein, which is associated with aggressive tumor behavior. The process of epithelial-mesenchymal transformation (EMT) is believed to play a critical role in tumor invasion, metastasis, and resistance to therapy in HER2-positive breast cancer. Tumor-infiltrating lymphocytes (TIL) are an important component of the host's immune response against cancer, and their presence and composition have been shown to correlate with clinical outcome in various types of cancer, including breast cancer. Our study aims to reveal the phenotypic heterogeneity of EMT in different tumor sites, including the primary tumor focus, tumor "Buds' ' and metastatic lymph nodes by molecular typing of HER2-enriched breast cancer. The expression of EMT markers, including E-cadherin, Beta-catenin and vimentin, was measured and significant differences in expression were detected. The presence of EMT in the main tumor focus and tumor "Buds'' was associated with a worse clinical outcome. Furthermore, the presence and composition of TILs varied between tumor sites and correlated with the expression of EMT markers. Based on the findings, it can be assumed that EMT is a heterogeneous process and that the presence of EMT in different tumor sites may have different clinical implications for HER2-positive breast cancer. Identification of biomarkers associated with EMT and TILs may facilitate the development of targeted therapies and improve personalized treatment for patients with HER2-positive breast cancer.
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