Breast cancer: origins and evolution

J Clin Invest. 2007 Nov;117(11):3155-63. doi: 10.1172/JCI33295.


Breast cancer is not a single disease, but rather is composed of distinct subtypes associated with different clinical outcomes. Understanding this heterogeneity is key for the development of targeted cancer-preventative and -therapeutic interventions. Current models explaining inter- and intratumoral diversity are the cancer stem cell and the clonal evolution hypotheses. Although tumor initiation and progression are predominantly driven by acquired genetic alterations, recent data implicate a role for microenvironmental and epigenetic changes as well. Comprehensive unbiased studies of tumors and patient populations have significantly advanced our molecular understanding of breast cancer, but translating these findings into clinical practice remains a challenge.

Publication types

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

MeSH terms

  • Breast Neoplasms / classification
  • Breast Neoplasms / etiology*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy
  • Cell Transformation, Neoplastic
  • Disease Progression
  • Epigenesis, Genetic
  • Female
  • Humans
  • Mammary Glands, Human / cytology
  • Mammary Glands, Human / pathology
  • Neoplasm Metastasis
  • Stem Cells / physiology