Molecular biology and genetics of breast cancer development: a clinical perspective

Understanding the molecular and genetic events affecting breast cancer development not only helps oncologists address important questions commonly asked by their patients but also helps clinicians gain insights into the biology of the disease. Although the molecular and genetic determinants of most sporadic breast cancer remain unknown, significant advances in the understanding of events that contribute to breast cancer formation have been made. It is now recognized that mutations in some tumor suppressor genes, such as p53, BRCA1, BRCA2, PTEN, or ATM, or epigenetic functional inactivation of other tumor suppressor genes, such as SYK and NES1, appear to play important early roles in the formation of some breast cancers. In addition, alterations in proto-oncogenes, such as HER2/neu, may contribute to the development of some breast cancer. The goal of this article is to further introduce clinicians to molecular and genetic pathways that contribute to breast cancer formation. By participating in the study of breast cancer development at the molecular as well as the histopathological level, oncologists can help develop novel prevention, diagnostic, and therapeutic approaches for the future.