breast

Led FAST-Forward, which cut breast radiotherapy from three weeks to one with no loss of effectiveness.

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.

Led ASCENT, the trial that made sacituzumab govitecan the first ADC for triple-negative breast cancer, and the EMERALD trial of elacestrant.

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.

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.

Translational oncologist who built genomic tests (HER2DX) to decide which HER2-positive patients can skip chemotherapy.

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.

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.

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.

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.

Brought sentinel node biopsy to breast cancer and led ACOSOG Z0011, which ended routine axillary dissection for many women.

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.

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.

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.

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.

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.

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.

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.

Led METABRIC, which used 2,000 tumours to define ten genomic subtypes of breast cancer and their long-term outcomes.

Defined the molecular subtypes of breast cancer (luminal, HER2-enriched, basal-like) that clinicians now use every day.

Led IMPORT LOW, which showed partial-breast radiotherapy is as effective as whole-breast treatment with fewer side effects.

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.

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.

Breast radiologist who co-developed the Mirai AI model that predicts breast cancer risk from a mammogram.

Spanish breast oncologist leading DESTINY-Breast09, which moved trastuzumab deruxtecan into first-line HER2-positive disease.

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.

Duke surgeon who led COMET, the trial testing whether women with low-risk DCIS can safely be monitored instead of having surgery straight away.

Surgeon who chairs the NRG Oncology breast committee and co-led the KATHERINE and B-42 trials.

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.

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.

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.

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.

Breast oncologist who led MONALEESA-2, the first CDK4/6 trial to show an overall survival gain in first-line HR-positive disease.

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.

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.

Led PERSEPHONE, which showed six months of trastuzumab is nearly as good as twelve for most patients.

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.

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.

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.

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.

Breast oncologist who took T-DM1 and then trastuzumab deruxtecan from first-in-human studies to approval.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Epidemiologist who led IBIS-I and IBIS-II, proving tamoxifen and anastrozole prevent breast cancer in high-risk women.

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).

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.

Led TAILORx, which showed most women with intermediate Oncotype scores can safely skip chemotherapy.

Statistician who ran the START, FAST-Forward and POETIC trials that reshaped breast cancer radiotherapy and endocrine therapy.

Led RxPONDER, which showed postmenopausal women with 1-3 positive nodes and low recurrence scores do not need chemotherapy.

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.

Leads the next wave of endocrine therapy: oral SERDs like imlunestrant and the PI3K inhibitor inavolisib.

Led MASAI, the first randomised trial of AI-supported mammography screening, which found more cancers with half the radiologist workload.

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.