乳腺癌是具有高度内部异质性的疾病,基于特异基因表达的分子分型包括Luminal A、Luminal B、HER-2过表达和Basal-like等亚型,并有效区分了乳腺癌的分子生物学行为和临床特点,得到广泛认可和应用.基于分子分型的乳腺癌流行病学中,对传统确认的乳腺癌危险因素,在不同乳腺癌亚型中的作用具有明显差异.乳腺癌的发病危险因素倾向于作为构成预后的保护性因素,这种矛盾可能与不同乳腺癌亚型之间的差异有关.未来的乳腺癌流行病学应注重针对分子亚型开展更加精准的研究,本文将对基于乳腺癌亚型的流行病学新认识进行综述.%Breast cancer is a group of diseases with considerable inner heterogeneity. Intrinsic subtyping has classified breast cancer into major subtypes, such as Luminal A, Luminal B, HER2-enriched, and basal-like breast carcinomas. This classification is based on the specific expression patterns of certain genes that effectively reflect each distinct biology and clinical outcome. Moreover, this classification is widely accepted and utilized. Epidemiological studies based on intrinsic subtyping shed a new light on breast cancer recognition. Traditionally validated risk factors showed substantial differences in their association with various intrinsic subtypes. The paradox of risk factors for breast cancer development generally exerting protective effects on patient survival has been observed. This phenomenon is highly likely caused by the heterogeneity among intrinsic subtypes. Future epidemiological studies on breast cancer should develop a further precise basis on the intrinsic subtypes, and this article will summarize the advances in epidemiology based on molecular subtyping of breast cancer.
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