The development and progression of breast cancer is a multistep process, the result of a series of genetic alterations occurring over the lifetime of a tumor. The search for specific alterations associated with the development and progression of breast tumors involves an intensive analysis of known genes and a search for new ones. Cellular oncogenes or tumor suppressor genes may be modified by gene mutation, rearrangement, amplification, deletion, epigenetic changes (such as methylation), other changes in RNA transcriptional regulation or processing, and post-translational modifications, all leading to altered protein function. Much of the recent work elucidating these various pathways is based on the hypothesis that identification of specific changes which occur in individual breast tumors will result in better predictive markers of clinical behavior and response to therapy.
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