{"slug":"breast","tag":"breast","variants":["breast"],"description":"Breast cancers and the people who work on them.","count":94,"kinds":{"cancer":26,"term":21,"roadmap":1,"institution":1,"person":40,"trial":5},"related":[{"slug":"tnbc","tag":"tnbc","shared":32},{"slug":"subtype-page","tag":"subtype-page","shared":21},{"slug":"trialist","tag":"trialist","shared":13},{"slug":"uk","tag":"uk","shared":10},{"slug":"de-escalation","tag":"de-escalation","shared":9},{"slug":"wave4","tag":"wave4","shared":9},{"slug":"radiotherapy","tag":"radiotherapy","shared":5},{"slug":"screening","tag":"screening","shared":5},{"slug":"adc","tag":"adc","shared":4},{"slug":"her2","tag":"her2","shared":4},{"slug":"prevention","tag":"prevention","shared":4},{"slug":"surgery","tag":"surgery","shared":4}],"records":[{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/","tldr":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/","tldr":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/","tldr":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."},{"id":"tnbc-basal-like-1","kind":"cancer","name":"Basal-like 1 triple-negative breast cancer (BL1)","route":"/cancers/tnbc-basal-like-1/","tldr":"Basal-like 1 is the subtype of triple-negative breast cancer whose cancer cells are busiest dividing and worst at repairing DNA. In the studies that defined it, these tumours were the most likely to disappear completely with chemotherapy before surgery, about four in ten, and their cell lines responded best to platinum drugs."},{"id":"tnbc-basal-like-2","kind":"cancer","name":"Basal-like 2 triple-negative breast cancer (BL2)","route":"/cancers/tnbc-basal-like-2/","tldr":"Basal-like 2 is a subtype of triple-negative breast cancer that shares the basal identity of basal-like 1 but is driven more by growth-factor signalling than by DNA damage, and it responded worst to standard chemotherapy before surgery in the studies that defined it, with pathological complete response in about one in five patients or fewer."},{"id":"tnbc-mesenchymal","kind":"cancer","name":"Mesenchymal triple-negative breast cancer (M)","route":"/cancers/tnbc-mesenchymal/","tldr":"Mesenchymal triple-negative breast cancers have switched on the programme cells use to migrate (epithelial-to-mesenchymal transition). They overlap with claudin-low and metaplastic tumours, respond to chemotherapy less well than basal-like 1 tumours, and are the subtype the parent page names as resisting every drug class."},{"id":"tnbc-mesenchymal-stem-like","kind":"cancer","name":"Mesenchymal stem-like triple-negative breast cancer (MSL)","route":"/cancers/tnbc-mesenchymal-stem-like/","tldr":"Mesenchymal stem-like was one of the six original subtypes of triple-negative breast cancer, marked by stem-cell and low-proliferation genes. Five years later the same group showed the signal came from stromal cells mixed into the sample rather than the cancer cells, so the label describes a tumour environment rather than a tumour."},{"id":"tnbc-luminal-androgen-receptor","kind":"cancer","name":"Luminal androgen receptor triple-negative breast cancer (LAR)","route":"/cancers/tnbc-luminal-androgen-receptor/","tldr":"Luminal androgen receptor cancers are triple-negative breast cancers that behave like hormone-driven tumours run by the male hormone receptor instead of oestrogen. They are less proliferative, respond less well to chemotherapy, and have shown modest benefit from prostate cancer drugs that block the androgen receptor in phase 2 trials; none is approved for breast cancer."},{"id":"tnbc-immunomodulatory","kind":"cancer","name":"Immunomodulatory triple-negative breast cancer (IM)","route":"/cancers/tnbc-immunomodulatory/","tldr":"Immunomodulatory triple-negative breast cancers are the ones packed with immune cells. The 2016 re-analysis showed the signature comes from those lymphocytes rather than the tumour, so today the same idea is captured by counting tumour-infiltrating lymphocytes on the biopsy, which predicts a better outcome and is used to test whether some small tumours need less treatment."},{"id":"metaplastic-breast-carcinoma","kind":"cancer","name":"Metaplastic breast carcinoma","route":"/cancers/metaplastic-breast-carcinoma/","tldr":"Metaplastic breast cancer is a rare form in which part of the tumour has changed into another tissue type, such as squamous skin-like cells, spindle cells or bone and cartilage. Most are triple-negative and they do worse than other triple-negative cancers, resisting chemotherapy; the low-grade forms are an exception with an excellent outlook."},{"id":"medullary-pattern-breast-carcinoma","kind":"cancer","name":"Carcinoma with medullary pattern (medullary breast cancer)","route":"/cancers/medullary-pattern-breast-carcinoma/","tldr":"Medullary breast cancers are high-grade, triple-negative tumours with a sharp border and a heavy immune-cell infiltrate that, despite looking aggressive, do better than ordinary breast cancers of the same grade. They are linked to BRCA1. Pathologists now call them a medullary pattern of common breast cancer rather than a type of their own."},{"id":"adenoid-cystic-carcinoma-breast","kind":"cancer","name":"Adenoid cystic carcinoma of the breast","route":"/cancers/adenoid-cystic-carcinoma-breast/","tldr":"Adenoid cystic carcinoma of the breast is a very rare breast cancer that is triple-negative on testing but behaves almost the opposite of usual triple-negative disease: it seldom reaches the lymph nodes, and nearly everyone is alive at ten years. It is the same tumour type as adenoid cystic carcinoma of the salivary glands and shares its gene fusion."},{"id":"apocrine-carcinoma-breast","kind":"cancer","name":"Apocrine carcinoma of the breast","route":"/cancers/apocrine-carcinoma-breast/","tldr":"Apocrine breast cancers are made of large cells resembling sweat-gland cells. They lack oestrogen and progesterone receptors but carry the androgen receptor, so the triple-negative ones sit in the luminal androgen receptor group and are the tumours in which androgen-blocking drugs have been tried."},{"id":"secretory-carcinoma-breast","kind":"cancer","name":"Secretory carcinoma of the breast","route":"/cancers/secretory-carcinoma-breast/","tldr":"Secretory carcinoma is a very rare, slow-growing breast cancer first described in children, whose cells make milk-like secretions. It is usually triple-negative but almost always carries the ETV6-NTRK3 gene fusion, so the rare patient whose tumour spreads can be treated with an NTRK inhibitor tablet, and most need no chemotherapy."},{"id":"brca-associated-tnbc","kind":"cancer","name":"BRCA-associated triple-negative breast cancer","route":"/cancers/brca-associated-tnbc/","tldr":"Some triple-negative breast cancers arise because a person was born with a faulty BRCA1 or BRCA2 gene. This group is diagnosed younger, is found by a blood test NICE recommends for all women under 50 with triple-negative disease, and has options of its own: platinum chemotherapy works well, a year of olaparib lowers relapse, and surgery decisions weigh the risk of a second cancer."},{"id":"er-pr-negative-threshold","kind":"term","name":"ER and PR negative under 1 percent (the triple-negative threshold, and ER-low)","route":"/terms/er-pr-negative-threshold/","tldr":"A breast cancer counts as oestrogen receptor negative when fewer than 1 in 100 of its cells stain for the receptor, and the same rule applies to progesterone receptor. Tumours with 1 to 10 percent staining are labelled ER low positive, but they behave like triple-negative cancers and in some countries are treated as such."},{"id":"her2-low-and-trop2-adc-eligibility-tnbc","kind":"term","name":"HER2-low eligibility for trastuzumab deruxtecan, and TROP2 ADCs without a test (triple-negative disease)","route":"/terms/her2-low-and-trop2-adc-eligibility-tnbc/","tldr":"Two antibody-drug conjugates reach triple-negative breast cancer by different rules. Trastuzumab deruxtecan needs the tumour to show a little HER2 (a score of 1+, or 2+ without gene amplification), so the pathologist's call between 0 and 1+ matters. Sacituzumab govitecan targets TROP2, which almost all breast cancers carry, and is given without any test."},{"id":"pd-l1-cps-10-tnbc","kind":"term","name":"PD-L1 combined positive score 10 in triple-negative breast cancer","route":"/terms/pd-l1-cps-10-tnbc/","tldr":"In metastatic triple-negative breast cancer the immunotherapy pembrolizumab is only given when a PD-L1 stain of the tumour scores 10 or more on the combined positive score, because that is the group in which the trial showed people lived longer. For early disease before surgery no PD-L1 test is needed: pembrolizumab helped regardless."},{"id":"hrd-in-breast-cancer","kind":"term","name":"Homologous recombination deficiency (HRD) in breast cancer","route":"/terms/hrd-in-breast-cancer/","tldr":"Homologous recombination deficiency means a tumour cannot mend double-strand DNA breaks properly, most often because BRCA1 or BRCA2 is lost. About seven in ten triple-negative tumours score as deficient, and they respond better to platinum chemotherapy; but unlike ovarian cancer, no breast cancer drug is approved on the basis of an HRD score, only on a germline BRCA result."},{"id":"germline-brca-testing-criteria-tnbc","kind":"term","name":"Germline BRCA testing criteria for triple-negative breast cancer (UK)","route":"/terms/germline-brca-testing-criteria-tnbc/","tldr":"In the NHS a blood test for inherited BRCA1 and BRCA2 faults is offered to every woman under 50 with triple-negative breast cancer, whatever her family history, and hospital testing criteria now extend that to triple-negative disease under 60 and any breast cancer under 40. Others are tested when a calculator puts the chance of a family fault at 10 percent or more."},{"id":"ki-67-in-tnbc","kind":"term","name":"Ki-67 in triple-negative breast cancer","route":"/terms/ki-67-in-tnbc/","tldr":"Ki-67 is a stain that marks dividing cells. Triple-negative cancers almost all score high, typically around 60 percent, so the marker separates them from slower hormone-driven cancers but rarely changes treatment within the triple-negative group; the international working group limits its clinical use to hormone receptor-positive disease."},{"id":"basal-like","kind":"term","name":"Basal-like breast cancer","route":"/terms/basal-like/","tldr":"Basal-like is a breast cancer subtype defined by the genes its cells switch on, which resemble the basal cells lining the milk ducts. About four in five triple-negative cancers are basal-like and most basal-like cancers are triple-negative, but the two labels are not the same thing, and the overlap is where BRCA1-related cancers sit."},{"id":"claudin-low","kind":"term","name":"Claudin-low breast cancer","route":"/terms/claudin-low/","tldr":"Claudin-low breast cancers have lost the claudin proteins that hold epithelial cells together and have taken on the features of migrating, stem-like cells. Most are triple-negative and respond to chemotherapy less well than basal-like cancers. Newer work treats claudin-low as a pattern that can overlay any subtype rather than a subtype of its own."},{"id":"androgen-receptor-positive-tnbc","kind":"term","name":"Androgen receptor-positive triple-negative breast cancer","route":"/terms/androgen-receptor-positive-tnbc/","tldr":"Some triple-negative breast cancers carry the androgen receptor, the protein that prostate cancer runs on. About one in eight ER-negative cancers stain positive, and in trials the prostate drugs bicalutamide and enzalutamide held the disease for a minority of patients; neither is approved for breast cancer, so this remains a trial question."},{"id":"ajcc-prognostic-stage-breast","kind":"term","name":"AJCC 8th edition prognostic stage for breast cancer","route":"/terms/ajcc-prognostic-stage-breast/","tldr":"Since 2018 the American staging system gives breast cancer two stages: the anatomic stage from tumour size, nodes and spread, and a prognostic stage that also counts grade and the three receptors. Because triple-negative cancers are usually grade 3 and receptor negative, their prognostic stage is often a step higher than their anatomic stage; UK pages and NICE quote the anatomic TNM stage."},{"id":"interval-breast-cancer","kind":"term","name":"Interval breast cancer (a cancer found between screening rounds)","route":"/terms/interval-breast-cancer/","tldr":"An interval breast cancer is one diagnosed after a normal screening mammogram and before the next invitation. Fast-growing cancers, triple-negative disease among them, make up a larger share of interval than of screen-detected cancers, which is why a new breast change should always be checked rather than left until the next screen."},{"id":"risk-reducing-surgery-brca-carriers","kind":"term","name":"Risk-reducing surgery for BRCA carriers (bilateral and contralateral mastectomy, salpingo-oophorectomy)","route":"/terms/risk-reducing-surgery-brca-carriers/","tldr":"Women who carry a BRCA1 or BRCA2 fault can choose to have both breasts removed before any cancer appears, which cuts breast cancer risk by about nine tenths, or to remove the other breast after a first cancer. Removing the ovaries protects against ovarian cancer but, in the largest prospective study, did not lower breast cancer risk in BRCA1 carriers."},{"id":"chemoprevention-and-er-negative-breast-cancer","kind":"term","name":"Chemoprevention (tamoxifen, anastrozole, raloxifene) and ER-negative breast cancer","route":"/terms/chemoprevention-and-er-negative-breast-cancer/","tldr":"Tamoxifen and anastrozole taken for five years cut the number of new breast cancers in women at raised risk by a third to a half, and NICE offers them to women at high or moderate risk. But the cancers they prevent are oestrogen-driven ones; in the trials they made no difference to oestrogen receptor-negative cancers, the kind BRCA1 carriers mostly get."},{"id":"founder-mutation","kind":"term","name":"Founder mutation (BRCA1 185delAG and 5382insC, BRCA2 6174delT)","route":"/terms/founder-mutation/","tldr":"A founder mutation is a single inherited gene fault that many people in one population share because they descend from the same ancestor who carried it. The best known are three BRCA faults carried by about one in forty Ashkenazi Jews, which is why Jewish ancestry is one of the family history flags in UK genetics referral rules."},{"id":"idfs","kind":"term","name":"Invasive disease-free survival (iDFS)","route":"/terms/idfs/","tldr":"Invasive disease-free survival is the yardstick of most trials that treat early breast cancer after surgery. A patient counts as an event if the cancer comes back anywhere as invasive disease, a new invasive cancer appears in either breast or elsewhere, or she dies of any cause; it deliberately ignores non-invasive recurrences. OlympiA used it to show that a year of olaparib helped BRCA carriers."},{"id":"luminal-androgen-receptor","kind":"term","name":"Luminal androgen receptor (LAR) subtype","route":"/terms/luminal-androgen-receptor/","tldr":"Luminal androgen receptor is one of the four molecular subtypes of triple-negative breast cancer. Its cells look and behave like hormone-driven luminal cells but run on the androgen receptor instead of oestrogen, which makes them slower growing, less responsive to chemotherapy and the target of trials with prostate cancer drugs."},{"id":"pd-l1-assay-discordance","kind":"term","name":"PD-L1 assay discordance (SP142, SP263 and 22C3 in breast cancer)","route":"/terms/pd-l1-assay-discordance/","tldr":"Three commercial PD-L1 stains give different answers on the same breast tumour: the SP142 assay used with atezolizumab called fewer than half of tumours positive while the 22C3 and SP263 assays called about three quarters. Because the pembrolizumab licence rests on 22C3 combined positive score 10, which test a laboratory runs, and how it scores it, decides who is offered immunotherapy."},{"id":"exceptional-responder","kind":"term","name":"Exceptional responder","route":"/terms/exceptional-responder/","tldr":"An exceptional responder is a patient whose cancer shrinks or stays controlled far longer than expected on a treatment that helps few people. The US National Cancer Institute defined the term for a study that sequenced such patients' tumours to learn why, and found a plausible molecular reason in about a quarter of them."},{"id":"health-disparities","kind":"term","name":"Health disparities in cancer outcomes (ethnicity, deprivation and access)","route":"/terms/health-disparities/","tldr":"Health disparities are differences in who gets a cancer and who survives it that track ethnicity, income and access to care rather than chance. Triple-negative breast cancer is the textbook case: Black women get it about twice as often, present later and die of it more often, and how much is biology and how much is unequal care is still being worked out on both sides of the Atlantic."},{"id":"tnbc-roadmap","kind":"roadmap","name":"Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem","route":"/roadmaps/tnbc-roadmap/","tldr":"Triple-negative breast cancer was named for what it lacks, the three receptors other breast cancers are treated through. This roadmap follows it from the receptor discoveries and the basal-like signature of 2000, through chemotherapy, platinum, PARP inhibitors, immunotherapy and antibody-drug conjugates, to the trials asking who can have less and who needs more, with registry dates to 2030."},{"id":"breast-cancer-now","kind":"institution","name":"Breast Cancer Now","route":"/institutions/breast-cancer-now/","tldr":"The UK's breast cancer research and support charity: a free nurse helpline, the Someone Like Me peer service, Moving Forward courses, an online forum and patient information on triple-negative disease, alongside funding of the Toby Robins Research Centre at the ICR."},{"id":"jean-abraham","kind":"person","name":"Jean Abraham","route":"/people/jean-abraham/","tldr":"Chief investigator of PARTNER, the UK trial of neoadjuvant olaparib with platinum chemotherapy in triple-negative and BRCA-associated breast cancer, run from Addenbrooke's across 23 NHS sites (30 on the ClinicalTrials.gov record)."},{"id":"ellen-copson","kind":"person","name":"Ellen Copson","route":"/people/ellen-copson/","tldr":"First author of POSH, the UK prospective cohort of young-onset breast cancer that showed germline BRCA carriers did no worse than non-carriers, and the ones with triple-negative disease did better in the first two years."},{"id":"anne-armstrong","kind":"person","name":"Anne Armstrong","route":"/people/anne-armstrong/","tldr":"Medical oncologist who co-chairs the breast disease group at The Christie, the Manchester cancer centre that is a site of the PHOENIX, PARTNER and ASCENT-05 trials for triple-negative disease."},{"id":"tnt","kind":"trial","name":"TNT (Triple Negative Trial)","route":"/trials/tnt/","status":"mixed","tldr":"The UK phase 3 trial that showed carboplatin is not better than docetaxel for triple-negative breast cancer as a whole, but is for the germline BRCA1/2 subgroup, and that gave the NHS its evidence for platinum in BRCA carriers."},{"id":"partner","kind":"trial","name":"PARTNER","route":"/trials/partner/","status":"positive","tldr":"The Cambridge-led UK trial that added olaparib to neoadjuvant carboplatin and paclitaxel for triple-negative and BRCA breast cancer and found the 48-hour gap schedule gave 100 percent three-year survival in the germline BRCA group."},{"id":"ibis-i","kind":"trial","name":"IBIS-I (International Breast Intervention Study I)","route":"/trials/ibis-i/","status":"positive","tldr":"The UK-led prevention trial that showed five years of tamoxifen keeps preventing breast cancer for at least twenty years, and the reason NICE tells the NHS to offer it to premenopausal women at high familial risk."},{"id":"ibis-ii","kind":"trial","name":"IBIS-II (International Breast Intervention Study II)","route":"/trials/ibis-ii/","status":"positive","tldr":"The trial that made anastrozole a prevention drug, halving breast cancer in postmenopausal women at high risk and, with a licence granted in 2023, putting a generic tablet on the NHS prevention pathway."},{"id":"agex","kind":"trial","name":"AgeX","route":"/trials/agex/","status":"mixed","tldr":"The largest randomised trial ever run inside a screening programme: nearly four million women cluster-randomised to an extra mammogram below 50 or above 70, and the reason the programme's age range has not moved."},{"id":"richard-finn","kind":"person","name":"Richard S. Finn","route":"/people/richard-finn/","tldr":"Led PALOMA-2, which made palbociclib a first-line breast cancer drug, and IMbrave150, which made immunotherapy the standard for liver cancer."},{"id":"massimo-cristofanilli","kind":"person","name":"Massimo Cristofanilli","route":"/people/massimo-cristofanilli/","tldr":"Showed that counting tumour cells in blood predicts survival in breast cancer and co-led PALOMA-3, which brought palbociclib to endocrine-resistant disease."},{"id":"gabriel-hortobagyi","kind":"person","name":"Gabriel N. Hortobagyi","route":"/people/gabriel-hortobagyi/","tldr":"Breast oncologist who led MONALEESA-2, the first CDK4/6 trial to show an overall survival gain in first-line HR-positive disease."},{"id":"stephen-johnston","kind":"person","name":"Stephen Johnston","route":"/people/stephen-johnston/","tldr":"Chief investigator of monarchE, the trial that added abemaciclib to adjuvant endocrine therapy for high-risk early breast cancer."},{"id":"komal-jhaveri","kind":"person","name":"Komal Jhaveri","route":"/people/komal-jhaveri/","tldr":"Leads the next wave of endocrine therapy: oral SERDs like imlunestrant and the PI3K inhibitor inavolisib."},{"id":"joseph-sparano","kind":"person","name":"Joseph A. Sparano","route":"/people/joseph-sparano/","tldr":"Led TAILORx, which showed most women with intermediate Oncotype scores can safely skip chemotherapy."},{"id":"kevin-kalinsky","kind":"person","name":"Kevin Kalinsky","route":"/people/kevin-kalinsky/","tldr":"Led RxPONDER, which showed postmenopausal women with 1-3 positive nodes and low recurrence scores do not need chemotherapy."},{"id":"prudence-francis","kind":"person","name":"Prudence A. Francis","route":"/people/prudence-francis/","tldr":"Led SOFT and TEXT, the trials that showed ovarian suppression plus exemestane helps young women with breast cancer."},{"id":"nadia-harbeck","kind":"person","name":"Nadia Harbeck","route":"/people/nadia-harbeck/","tldr":"German breast oncologist whose ADAPT trials use biology to decide who can have less chemotherapy."},{"id":"mitch-dowsett","kind":"person","name":"Mitch Dowsett","route":"/people/mitch-dowsett/","tldr":"The translational scientist behind the aromatase inhibitor era and the Ki67 response test used in POETIC."},{"id":"jack-cuzick","kind":"person","name":"Jack Cuzick","route":"/people/jack-cuzick/","tldr":"Epidemiologist who led IBIS-I and IBIS-II, proving tamoxifen and anastrozole prevent breast cancer in high-risk women."},{"id":"charles-perou","kind":"person","name":"Charles M. Perou","route":"/people/charles-perou/","tldr":"Defined the molecular subtypes of breast cancer (luminal, HER2-enriched, basal-like) that clinicians now use every day."},{"id":"sandra-swain","kind":"person","name":"Sandra M. Swain","route":"/people/sandra-swain/","tldr":"Led CLEOPATRA, which showed dual HER2 blockade with pertuzumab gives an unprecedented 16-month survival gain in metastatic disease."},{"id":"ian-krop","kind":"person","name":"Ian E. Krop","route":"/people/ian-krop/","tldr":"Breast oncologist who took T-DM1 and then trastuzumab deruxtecan from first-in-human studies to approval."},{"id":"shanu-modi","kind":"person","name":"Shanu Modi","route":"/people/shanu-modi/","tldr":"Led DESTINY-Breast01 and DESTINY-Breast04, the trials that created the HER2-low category and opened T-DXd to most breast cancers."},{"id":"cristina-saura","kind":"person","name":"Cristina Saura","route":"/people/cristina-saura/","tldr":"Spanish breast oncologist leading DESTINY-Breast09, which moved trastuzumab deruxtecan into first-line HER2-positive disease."},{"id":"helena-earl","kind":"person","name":"Helena Earl","route":"/people/helena-earl/","tldr":"Led PERSEPHONE, which showed six months of trastuzumab is nearly as good as twelve for most patients."},{"id":"aleix-prat","kind":"person","name":"Aleix Prat","route":"/people/aleix-prat/","tldr":"Translational oncologist who built genomic tests (HER2DX) to decide which HER2-positive patients can skip chemotherapy."},{"id":"eleftherios-mamounas","kind":"person","name":"Eleftherios P. Mamounas","route":"/people/eleftherios-mamounas/","tldr":"Surgeon who chairs the NRG Oncology breast committee and co-led the KATHERINE and B-42 trials."},{"id":"aditya-bardia","kind":"person","name":"Aditya Bardia","route":"/people/aditya-bardia/","tldr":"Led ASCENT, the trial that made sacituzumab govitecan the first ADC for triple-negative breast cancer, and the EMERALD trial of elacestrant."},{"id":"monica-morrow","kind":"person","name":"Monica Morrow","route":"/people/monica-morrow/","tldr":"Breast surgeon whose margin and axillary guidelines cut unnecessary re-excisions and lymph node surgery worldwide."},{"id":"armando-giuliano","kind":"person","name":"Armando E. Giuliano","route":"/people/armando-giuliano/","tldr":"Brought sentinel node biopsy to breast cancer and led ACOSOG Z0011, which ended routine axillary dissection for many women."},{"id":"carlos-caldas","kind":"person","name":"Carlos Caldas","route":"/people/carlos-caldas/","tldr":"Led METABRIC, which used 2,000 tumours to define ten genomic subtypes of breast cancer and their long-term outcomes."},{"id":"charlotte-coles","kind":"person","name":"Charlotte E. Coles","route":"/people/charlotte-coles/","tldr":"Led IMPORT LOW, which showed partial-breast radiotherapy is as effective as whole-breast treatment with fewer side effects."},{"id":"murray-brunt","kind":"person","name":"A. Murray Brunt","route":"/people/murray-brunt/","tldr":"Led FAST-Forward, which cut breast radiotherapy from three weeks to one with no loss of effectiveness."},{"id":"timothy-whelan","kind":"person","name":"Timothy J. Whelan","route":"/people/timothy-whelan/","tldr":"Led the Canadian trials that established three-week breast radiotherapy and defined when nodal radiotherapy helps."},{"id":"kristina-lang","kind":"person","name":"Kristina Lång","route":"/people/kristina-lang/","tldr":"Led MASAI, the first randomised trial of AI-supported mammography screening, which found more cancers with half the radiologist workload."},{"id":"constance-lehman","kind":"person","name":"Constance D. Lehman","route":"/people/constance-lehman/","tldr":"Breast radiologist who co-developed the Mirai AI model that predicts breast cancer risk from a mammogram."},{"id":"richard-gray","kind":"person","name":"Richard Gray","route":"/people/richard-gray/","tldr":"Statistician behind the Early Breast Cancer Trialists' meta-analyses that set the global evidence base for adjuvant therapy."},{"id":"judith-bliss","kind":"person","name":"Judith M. Bliss","route":"/people/judith-bliss/","tldr":"Statistician who ran the START, FAST-Forward and POETIC trials that reshaped breast cancer radiotherapy and endocrine therapy."},{"id":"rashmi-murthy","kind":"person","name":"Rashmi K. Murthy","route":"/people/rashmi-murthy/","tldr":"Houston breast cancer doctor who was lead author of HER2CLIMB, the trial that established tucatinib for HER2-positive breast cancer, including in patients with brain metastases."},{"id":"rupert-bartsch","kind":"person","name":"Rupert Bartsch","route":"/people/rupert-bartsch/","tldr":"Vienna oncologist who led TUXEDO-1, the small trial that showed trastuzumab deruxtecan can shrink active brain metastases from HER2-positive breast cancer."},{"id":"mark-robson","kind":"person","name":"Mark E. Robson","route":"/people/mark-robson/","tldr":"New York breast oncologist and cancer geneticist who led OlympiAD, the trial that made olaparib the first PARP inhibitor approved for BRCA-mutated breast cancer."},{"id":"andrea-decensi","kind":"person","name":"Andrea DeCensi","route":"/people/andrea-decensi/","tldr":"Italian oncologist who led TAM-01, the trial that showed a low dose of tamoxifen halves recurrence after non-invasive breast cancer with fewer side effects than the standard dose."},{"id":"shelley-hwang","kind":"person","name":"E. Shelley Hwang","route":"/people/shelley-hwang/","tldr":"Duke surgeon who led COMET, the trial testing whether women with low-risk DCIS can safely be monitored instead of having surgery straight away."},{"id":"luca-gianni","kind":"person","name":"Luca Gianni","route":"/people/luca-gianni/","tldr":"Milan oncologist who led NeoSphere, the trial that showed adding pertuzumab to trastuzumab and docetaxel before surgery clears more HER2-positive breast cancers, the basis for pertuzumab's neoadjuvant approval."},{"id":"jose-baselga","kind":"person","name":"José Baselga","route":"/people/jose-baselga/","tldr":"Spanish oncologist who helped develop trastuzumab, pertuzumab and everolimus for breast cancer, and was lead author of BOLERO-2, which established everolimus plus exemestane for hormone-receptor-positive disease."},{"id":"second-primary-breast-after-chest-radiotherapy","kind":"term","name":"Breast cancer after chest radiotherapy given young","route":"/terms/second-primary-breast-after-chest-radiotherapy/","tldr":"This is the second cancer with a real screening programme attached, and the one most worth asking about by name. A woman who had radiotherapy to breast tissue between the ages of 10 and 35, most often for Hodgkin lymphoma, is eligible in England for annual magnetic resonance imaging from age 25 or 30, and being missed from that list has happened often enough that asking is reasonable."},{"id":"rejuv-second-uk-very-high-risk-breast-screening","kind":"term","name":"The UK very high risk breast screening protocol after chest radiotherapy","route":"/terms/rejuv-second-uk-very-high-risk-breast-screening/","tldr":"England runs a named screening programme for women who had radiotherapy to breast tissue when young, with exact ages and tests set out in its own documents. Surveillance begins at 25 or 30 depending on your age when irradiated, or eight years after the radiotherapy, whichever is later, and referral runs through a national dataset."},{"id":"male-breast-cancer","kind":"cancer","name":"Male breast cancer","route":"/cancers/male-breast-cancer/","tldr":"Men get breast cancer too, usually a hormone-sensitive kind found as a lump near the nipple. It is treated much as in women, with surgery, radiotherapy and tamoxifen, and inherited BRCA2 mutations are found often enough that every man diagnosed is offered genetic testing. The main fix under way is including men in trials so their care stops being borrowed from women."},{"id":"ductal-carcinoma-in-situ","kind":"cancer","name":"Ductal carcinoma in situ (DCIS)","route":"/cancers/ductal-carcinoma-in-situ/","tldr":"DCIS is abnormal cells confined to the milk ducts of the breast; it is not yet invasive cancer and cannot spread, but some would become invasive if left. Lumpectomy with radiotherapy, or mastectomy, halves local recurrence, so the live question is which low-risk DCIS can safely be watched: the COMET trial (2024) found active monitoring no worse at two years."},{"id":"invasive-lobular-carcinoma","kind":"cancer","name":"Invasive lobular carcinoma of the breast","route":"/cancers/invasive-lobular-carcinoma/","tldr":"Invasive lobular carcinoma is the second most common type of breast cancer, about one in seven cases. Its cells have lost the glue protein E-cadherin, so they spread in single files rather than forming a lump, which makes it hard to see on mammograms and to measure. Almost all cases are hormone-receptor positive and are treated like other hormone-driven breast cancer."},{"id":"invasive-breast-carcinoma-no-special-type","kind":"cancer","name":"Invasive breast carcinoma of no special type (invasive ductal carcinoma)","route":"/cancers/invasive-breast-carcinoma-no-special-type/","tldr":"Invasive carcinoma of no special type, still widely called invasive ductal carcinoma, is the ordinary form of breast cancer and by far the most common. The name means the tumour has no special pattern that would put it in one of the rarer types; everything on the main breast cancer page and its receptor subpages is written about this type unless it says otherwise."},{"id":"tubular-carcinoma-breast","kind":"cancer","name":"Tubular carcinoma of the breast","route":"/cancers/tubular-carcinoma-breast/","tldr":"Tubular carcinoma is a rare, slow-growing type of breast cancer made of small, well-formed tubes, usually found small on a screening mammogram. Its outlook is excellent, better even than other grade 1 breast cancers, and it is treated with surgery, radiotherapy where the breast is kept, and hormone therapy."},{"id":"mucinous-carcinoma-breast","kind":"cancer","name":"Mucinous carcinoma of the breast","route":"/cancers/mucinous-carcinoma-breast/","tldr":"Mucinous carcinoma is a rare type of breast cancer in which the cancer cells float in pools of mucus they have made. It is usually hormone-receptor positive, slow-growing and less likely to reach the lymph nodes than ordinary breast cancer, so its outlook is good and it is treated like other hormone-driven breast cancer."},{"id":"papillary-carcinoma-breast","kind":"cancer","name":"Papillary carcinomas of the breast (encapsulated, solid and invasive papillary)","route":"/cancers/papillary-carcinoma-breast/","tldr":"Papillary carcinomas are rare breast cancers, about one in a hundred, that grow as finger-like fronds on stalks, often inside a cyst, mostly in older women. The encapsulated and solid forms behave almost like non-invasive disease and have an excellent outlook; the truly invasive papillary form is treated like ordinary hormone-driven breast cancer."},{"id":"invasive-cribriform-carcinoma-breast","kind":"cancer","name":"Invasive cribriform carcinoma of the breast","route":"/cancers/invasive-cribriform-carcinoma-breast/","tldr":"Invasive cribriform carcinoma is a rare, low-grade type of breast cancer whose cells grow in sieve-like nests, closely related to tubular carcinoma. In its pure form it has an excellent outlook, with no deaths from the cancer in the defining series, and it is treated like other hormone-driven breast cancer with the least treatment possible."},{"id":"invasive-micropapillary-carcinoma-breast","kind":"cancer","name":"Invasive micropapillary carcinoma of the breast","route":"/cancers/invasive-micropapillary-carcinoma-breast/","tldr":"Invasive micropapillary carcinoma is a rare type of breast cancer in which small clusters of cells float inside-out in empty spaces. It spreads to the lymph nodes far more often than ordinary breast cancer of the same size, but once that is allowed for its survival is similar, and it is treated by receptor status like other breast cancer, usually hormone-driven."},{"id":"neuroendocrine-neoplasms-breast","kind":"cancer","name":"Neuroendocrine neoplasms of the breast","route":"/cancers/neuroendocrine-neoplasms-breast/","tldr":"Neuroendocrine neoplasms of the breast are rare breast cancers whose cells make hormone-like granules, ranging from slow-growing tumours to small cell carcinoma like that of the lung. They are easily mistaken for ordinary breast cancer or for spread from elsewhere; slow-growing forms are treated like hormone-driven breast cancer and small cell forms with the lung small cell regimens."},{"id":"lobular-carcinoma-in-situ","kind":"cancer","name":"Lobular carcinoma in situ (LCIS)","route":"/cancers/lobular-carcinoma-in-situ/","tldr":"Lobular carcinoma in situ is not an invasive breast cancer but a marker that a woman is at higher risk of one: abnormal cells fill the milk-producing lobules without spreading. About one in five women develop breast cancer within ten years, in either breast and of any type; preventive tamoxifen cuts that to about one in fourteen, and the pleomorphic form is excised like ductal carcinoma in situ."}]}