Tertiary lymphoid structures in breast cancer: formation, immune functions and clinical implications
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By
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Wenting Dong
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Shichao Ai
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Xiaofei Shen
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Yongzhong Yao
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June 2, 2026
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Clinical Scorecard: Tertiary Lymphoid Structures in Breast Cancer: Development, Immune Roles, and Clinical Significance
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | TLS development influenced by chronic inflammation, stromal activation, chemokine-guided immune cell recruitment, and lymphocyte trafficking. |
| Target Population | |
| Care Setting | |
Key Highlights
- TLS are ectopic lymphoid aggregates that arise in non-lymphoid tissues under chronic inflammatory conditions.
- TLS maturation includes early TLS (eTLS), primary follicle-like TLS (pTLS), and mature TLS (mTLS).
- The significance of TLS in breast cancer is heterogeneous and context-dependent.
Guideline-Based Recommendations
Diagnosis
- TLS identification through histopathology, immunophenotyping, multiplex imaging, and transcriptomic inference.
Management
Monitoring & Follow-up
- Assessment of TLS maturation and composition as part of patient monitoring.
Risks
- Variability in TLS maturity and immune composition may complicate prognostic interpretations.
Patient & Prescribing Data
Women diagnosed with breast cancer across various molecular subtypes.
TLS may influence therapeutic responsiveness and prognosis, but their role is complex.
Clinical Best Practices
- Standardize classification criteria for TLS to enhance clinical relevance.
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