Multistep tumorigenesis and the microenvironment

Breast Cancer Res. 2004;6(2):93-101. doi: 10.1186/bcr772. Epub 2004 Feb 12.


Early-stage cancers have long been considered to be less aggressive than late-stage cancers because it is assumed that they have accumulated fewer of the mutations that are required for full metastatic potential. For breast cancer, recent gene expression profiling data have challenged this paradigm by identifying early-stage cancers with similar gene expression profiles to fully metastatic cancers. In this review, multistep carcinogenesis is reconsidered in light of these new data. The concept that the tumor stroma plays a key role in determining whether a metastatic tumor cell will remain dormant or become invasive is discussed. Recent studies demonstrating the feasibility of targeting tumor stroma for cancer prevention and treatment are presented.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / secondary*
  • Gene Expression Profiling
  • Gene Expression Regulation, Neoplastic / genetics
  • Genes, Neoplasm / genetics
  • Humans
  • Neoplasm Metastasis / genetics