{
  "abstract": "Young breast cancer (YBC), defined as diagnosis at or before the age of 40 years, is characterized by an aggressive phenotype and poor prognosis. The tumor microenvironment (TME), comprising immune and stromal cells, plays a critical role in tumor initiation and progression and is closely associated with clinical outcomes. However, alterations in cell states and the organization of multicellular ecosystems within the YBC microenvironment remain poorly understood. We analyzed 7379 bulk transcriptome samples and spatial transcriptomic data from eight samples using EcoTyper and complementary spatial analyses. The abundance of CD4+ T cells (S07), fibroblasts (S05), monocytes/macrophages (S09), and epithelial cells (S05) was significantly lower in young than in older patients with breast cancer. CD4+ T cells (S07), fibroblasts (S05), and monocytes/macrophages (S09) formed a spatially organized multicellular ecosystem with putative interactions involving CDH1-PTPRF/ERBB3. Lower ecosystem abundance was associated with poorer prognosis, including among patients who did not achieve a pathological complete response after neoadjuvant therapy. These findings identify a distinct multicellular ecosystem within the YBC microenvironment, providing insights into the microenvironmental features associated with disease progression.",
  "abstract_shown": true,
  "affiliations": [
    "Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.",
    "Guangdong Provincial Clinical Research Center for Breast Diseases, Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.",
    "Zenith Institute of Medical Sciences, Guangzhou, Guangdong, China.",
    "Guangdong Provincial Key Laboratory of Cancer Pathogenesis and Precision Diagnosis and Treatment, Shenshan Medical Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Shanwei, Guangdong, China.",
    "Department of Breast Surgery, Shenshan Medical Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Shanwei, Guangdong, China.",
    "Department of General Surgery (Breast Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiaolin Chen",
      "orcid": "0009-0007-4428-5748"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Zhuozhi Liang"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Xinming Chen"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Qian Ouyang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Qianru Chen"
    },
    {
      "affs": [
        0,
        1,
        4
      ],
      "name": "Liling Zhu"
    },
    {
      "affs": [
        5
      ],
      "name": "Shunrong Li"
    },
    {
      "affs": [
        1,
        3,
        4
      ],
      "name": "Kai Chen",
      "orcid": "0000-0002-7052-4681"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4q4gw0af7rxw0.bib",
  "cited_by": 0,
  "doi": "10.1002/cam4.72367",
  "fulltext_url": "https://europepmc.org/articles/PMC13680547",
  "id": "4q4gw0af7rxw0",
  "issns": [
    "2045-7634"
  ],
  "landing_url": "https://europepmc.org/article/MED/42897436",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC254-282"
    ],
    [
      "openalex",
      "1312|Single-cell and spatial transcriptomics"
    ]
  ],
  "openalex": "W7222936498",
  "pdf_url": "https://europepmc.org/articles/PMC13680547?pdf=render",
  "pmcid": "PMC13680547",
  "pmid": "42897436",
  "published": "2026-10-01",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/4q4gw0af7rxw0.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42897436",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42897436"
    },
    {
      "first_seen": "2026-10-30T13:44:29Z",
      "native_id": "23bf40b234b946f09511da7471e5b431",
      "source": "doaj",
      "url": "https://doi.org/10.1002/cam4.72367"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1312|Single-cell and spatial transcriptomics",
      "subfield": "molecular-biology"
    }
  ],
  "title": "Integrated Spatial and Bulk Transcriptomic Analysis Identifies a Multicellular Ecosystem Involved in Progression of Young Breast Cancer.",
  "title_text": "Integrated Spatial and Bulk Transcriptomic Analysis Identifies a Multicellular Ecosystem Involved in Progression of Young Breast Cancer.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:44:29Z",
  "url": "https://research.draconitic.com/paper/4q4gw0af7rxw0",
  "venue": "Cancer medicine",
  "versions": []
}