ArticleProceedings of the National Academy of Sciences of the United States of America2026
Spatial transcriptomics reveals tumor microenvironment-driven subtypes of invasive lobular carcinoma.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Toward targeted therapeutics for lobular breast cancer.The Journal of clinical investigation · 2026Review
- Spatial Transcriptomics Recontextualizes the Cellular Environment of Conjunctival Melanoma.medRxiv : the preprint server for health sciences · 2026Article
- Decoding the breast cancer microenvironment by spatial multi-omics: from architecture to clinical translation.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
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Authors and funding
14 authors.
Funding
Abstract
Invasive lobular carcinoma (ILC) is the second most common histological subtype of breast cancer and displays distinct clinical and biological behavior compared to breast cancer of no special type. However, current molecular classifications largely overlook its complex spatial organization and tumor microenvironment (TME). Here, we performed spatial transcriptomics on 43 hormone receptor-positive, HER2-negative (HR+/HER2-) ILC tumors with detailed morphological annotation and long-term clinical follow-up. By integrating spatial gene expression with histology and single-cell deconvolution, we characterized the composition and architecture of the TME and revealed high inter- and intratumor heterogeneity. Spatial clustering uncovered cell populations and pathways linked to clinical outcome. We then developed a multimodal classification of ILC by integrating gene expression, morphology, and spatial metrics, identifying four distinct subtypes: normal/stroma-enriched (NSE), proliferative (P), androgen receptor-enriched (ARE), and metabolic/immune-enriched (MIE). These subtypes, collectively termed ILC4TME, reflect the interplay between tumor and microenvironmental features. Gene signatures derived from the spatial data enabled subtype assignment in external bulk RNA-seq and microarray datasets (SCAN-B, METABRIC), revealing reproducible biology and significant associations with survival. In multivariable models, ILC4TME retained prognostic value beyond established gene signatures and clinicopathological variables. Notably, the P subtype was linked to poor prognosis, even in patients treated with endocrine therapy alone, while the NSE subtype was associated with favorable outcomes. Our findings uncover spatial and cellular heterogeneity in ILC that is not captured by existing classification approaches, offering a refined framework for risk stratification and therapeutic targeting based on tumor microenvironment architecture.
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