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Breast Cancer Metastasis and Drug Resistance pp 65–95Cite as

Breast Cancer Heterogeneity in Primary and Metastatic Disease

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Abstract

The term ‘breast cancer’ describes a heterogeneous collection of neoplasms arising from the mammary epithelium. Tumors in different patients display diverse morphologies, molecular phenotypes, responses to therapy, probabilities of relapse and overall survival. Current histopathological classification systems aim to categorise tumors into subgroups to inform patient management decisions, but the diversity within subgroups is considerable. Molecular analyses such as gene expression profiling, and more recently, massively parallel sequencing technologies, have been employed to increase the degree of resolution in breast cancer taxonomies. It will take time for this information to be translated into the clinic. Sequencing projects have also been instrumental in revealing the true extent of intratumoral heterogeneity: three-dimensional variability in the genetic, phenotypic, cellular and microenvironmental constitution of individual tumors. This variability underlies clinical problems such as metastasis and drug resistance, and will present additional challenges as breast cancer diagnostics evolves to include higher resolution molecular analyses. Intratumoral heterogeneity will need to be carefully considered as we move towards more personalized models of breast cancer patient management.

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Acknowledgments

The authors are grateful to Ms Rebecca Johnston and Dr Ana Cristina Vargas for critical review and assistance with preparation of this manuscript. We would also like to acknowledge our funding agencies: The Australian National Health and Medical Research Council, The Qld Cancer Council, Pathology Queensland, The Queensland Health Pathology and Scientific Services Study, Education and Research Trust Fund (SERTF), The Royal Brisbane and Women’s Hospital and The University of Queensland.

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Authors and Affiliations

  1. The University of Queensland, UQ Centre for Clinical Research, Royal Brisbane and Women’s Hospital, Herston, Qld, 4029, Australia

    Jodi M. Saunus, Amy McCart-Reed, Majid Momeny, Margaret Cummings & Sunil R. Lakhani

  2. Pathology Queensland, The Royal Brisbane & Women’s Hospital, Herston, Qld, 4029, Australia

    Margaret Cummings & Sunil R. Lakhani

  3. The University of Queensland, School of Medicine, Herston, Qld, 4029, Australia

    Margaret Cummings & Sunil R. Lakhani

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  1. Jodi M. Saunus
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Correspondence to Jodi M. Saunus .

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  1. School of Medicine, Karmanos Cancer Institute, Wayne State University, John R Street 4100, Detroit, 48201, Michigan, USA

    Aamir Ahmad

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Saunus, J.M., McCart-Reed, A., Momeny, M., Cummings, M., Lakhani, S.R. (2013). Breast Cancer Heterogeneity in Primary and Metastatic Disease. In: Ahmad, A. (eds) Breast Cancer Metastasis and Drug Resistance. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5647-6_5

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