Suzanne A Eccles, The Institute of Cancer Research, London
Eric O. Aboagye, Imperial College London
Simak Ali, Imperial College London
Annie S. Anderson, University of Dundee
Jo Armes, Kings College London
Fedor Berditchevski, University of Birmingham
Jeremy P. Blaydes, University of Southampton
Keith Brennan, University of Manchester
Nicola J. Brown, University of Sheffield
Helen E. Bryant, University of Sheffield
Nigel J. Bundred, University of Manchester
Joy M. Burchell, Kings College London
Anna M. Campbell, University of Dundee
Jason S. Carroll, University of Cambridge
Robert B. Clarke, University of Manchester
Charlotte E. Coles, Cambridge University Hospitals NHS Foundation Trust
Gary Jr Cook, Kings College London
Angela Cox, University of Sheffield
Nicola J. Curtin, Newcastle University
Lodewijk V V. Dekker, University of Nottingham
Isabel Dos Santos Silva, London School of Hygiene and Tropical Medicine
Stephen W. Duffy, Queen Mary University of London
Douglas F. Easton, University of Cambridge
Diana M. Eccles, University of Southampton
Dylan R. Edwards, University of East Anglia
Joanne Edwards, University of Glasgow
D Gareth Evans, University of Manchester
Deborah F. Fenlon, University of Southampton
James M. Flanagan, Imperial College London
Claire Foster, University of Southampton
William M. Gallagher, University College Dublin
Montserrat Garcia-Closas, The Institute of Cancer Research, London
Julia MW Gee, University of Cardiff
Andy J. Gescher, University of Leicester
Vicky Goh, Kings College London
Ashley M. Groves, University College London
Amanda J. Harvey, Brunel University
Michelle Harvie, University of Manchester
Bryan T. Hennessy, Royal College of Surgeons in Ireland
Stephen Hiscox, University of Cardiff
Ingunn Holen, University of Sheffield
Sacha J. Howell, University of Manchester
Anthony Howell, University of Manchester
Gill Hubbard, University of Stirling
Nick Hulbert-Williams, University of Chester
Myra S. Hunter, Kings College London
Bharat Jasani, University of Cardiff
Louise J. Jones, Queen Mary University of London
Timothy J. Key, University of Oxford
Cliona C. Kirwan, University of Manchester
Anthony Kong, University of Oxford
Ian H. Kunkler, University of Edinburgh
Simon P. Langdon, University of Edinburgh
Martin O. Leach, The Institute of Cancer Reserch, London
David J. Mann, Imperial College London
John F. Marshall, Queen Mary University of London
Lesley A. Martin, The Institute of Cancer Research, London
Stewart G. Martin, University of Nottingham
Jennifer E. Macdougall, National Cancer Research Institute, London
David W. Miles, University of Edinburgh
William R. Miller, University of Edinburgh
Joanna R. Morris, University of Birmingham
Sue M. Moss, Queen Mary University of London
Paul Mullan, Queen's University, Belfast
Rachel Natrajan, The Institute of Cancer Research, London
James PB O'Connor, University of Manchester
Rosemary O'Connor, University College Cork
Carlo Palmieri, University of Liverpool
Paul DP Pharoah, University of Cambridge
Emad A. Rakha, University of Nottingham
Elizabeth Reed, Princess Alice Hospital
Simon P. Robinson, The Institute of Cancer Research, London
Erik Sahai, London Research Institute
John M. Saxton, University of East Anglia
Peter Schmid, University of Sussex
Matthew J. Smalley, University of Cardiff
Valerie Speirs, University of Leeds
Robert Stein, University College London
John Stingl, University of Cambridge
Charles H. Streuli, University of Manchester
Andrew NJ Tutt, Kings College London
Galina Velikova, University of Leeds
Rosemary A. Walker, University of Leicester
Christine J. Watson, University of Cambridge
Kaye J. Williams, University of Manchester
Leonie S. Young, Royal College of Surgeons in Ireland
Alastair M. Thompson, University of Dundee

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Afatinib, ATM protein, biological marker, BRCA1 protein, BRCA2 protein, checkpoint kinase 2, denosumab, everolimus, fenretinide, ganetespib, goserelin, lapatinib, lasofoxifene, letrozole, luminespib, metformin, neratinib, paclitaxel, pertuzumab, phosphatidylinositol 3, 4, 5 trisphosphate 3 phosphatase, protein kinase LKB1, protein p53, raloxifene, resveratrol, saracatinib, tamoxifen, trastuzumab, uvomorulin, abdominal obesity, advanced cancer, alcohol consumption, allele, angiogenesis, article, behavior change, bioinformatics, body composition, body weight, bone metastasis, breast cancer, breast development, breast metastasis, breast reconstruction, caloric restriction, cancer adjuvant therapy, cancer epidemiology, cancer genetics, cancer hormone therapy, cancer immunotherapy, cancer prognosis, cancer risk, cancer survival, cancer susceptibility, cell death, cell lineage, cell polarity, chemosensitivity, circulating tumor cell, clinical decision making, cognitive therapy, cost effectiveness analysis, cytology, distant metastasis, DNA damage, drug efficacy, epigenetics, epithelial mesenchymal transition, exercise, fat intake, fine needle aspiration biopsy, gene expression, genetic association, genetic predisposition, genetic screening, genetic susceptibility, genetic variability, genotype, hormonal therapy, human, in vitro study, in vivo study, lifestyle modification, longevity, low drug dose, lymphangiogenesis, malignant transformation, mastectomy, medical research, meta analysis (topic), micrometastasis, molecularly targeted therapy, monotherapy, nonhuman, nuclear magnetic resonance imaging, patient satisfaction, personalized medicine, phase 3 clinical trial (topic), physical activity, positron emission tomography, psychological well being, quality of life, radiofrequency ablation, radiosensitivity, randomized controlled trial (topic), signal transduction, single nucleotide polymorphism, smoking, social marketing, stereotactic body radiation therapy, terminal care, translational research, tumor microenvironment, tumor xenograft.


The original article is available at


INTRODUCTION: Breast cancer remains a significant scientific, clinical and societal challenge. This gap analysis has reviewed and critically assessed enduring issues and new challenges emerging from recent research, and proposes strategies for translating solutions into practice.

METHODS: More than 100 internationally recognised specialist breast cancer scientists, clinicians and healthcare professionals collaborated to address nine thematic areas: genetics, epigenetics and epidemiology; molecular pathology and cell biology; hormonal influences and endocrine therapy; imaging, detection and screening; current/novel therapies and biomarkers; drug resistance; metastasis, angiogenesis, circulating tumour cells, cancer 'stem' cells; risk and prevention; living with and managing breast cancer and its treatment. The groups developed summary papers through an iterative process which, following further appraisal from experts and patients, were melded into this summary account.

RESULTS: The 10 major gaps identified were: (1) understanding the functions and contextual interactions of genetic and epigenetic changes in normal breast development and during malignant transformation; (2) how to implement sustainable lifestyle changes (diet, exercise and weight) and chemopreventive strategies; (3) the need for tailored screening approaches including clinically actionable tests; (4) enhancing knowledge of molecular drivers behind breast cancer subtypes, progression and metastasis; (5) understanding the molecular mechanisms of tumour heterogeneity, dormancy, de novo or acquired resistance and how to target key nodes in these dynamic processes; (6) developing validated markers for chemosensitivity and radiosensitivity; (7) understanding the optimal duration, sequencing and rational combinations of treatment for improved personalised therapy; (8) validating multimodality imaging biomarkers for minimally invasive diagnosis and monitoring of responses in primary and metastatic disease; (9) developing interventions and support to improve the survivorship experience; (10) a continuing need for clinical material for translational research derived from normal breast, blood, primary, relapsed, metastatic and drug-resistant cancers with expert bioinformatics support to maximise its utility. The proposed infrastructural enablers include enhanced resources to support clinically relevant in vitro and in vivo tumour models; improved access to appropriate, fully annotated clinical samples; extended biomarker discovery, validation and standardisation; and facilitated cross-discipline working.

CONCLUSIONS: With resources to conduct further high-quality targeted research focusing on the gaps identified, increased knowledge translating into improved clinical care should be achievable within five years.


Medicine and Health Sciences | Surgery


Eccles SA, Aboagye EO, Ali S, Anderson AS, Armes J, Berditchevski F, Blaydes JP, Brennan K, Brown NJ, Bryant HE, Bundred NJ, Burchell JM, Campbell AM, Carroll JS, Clarke RB, Coles CE, Cook GJ, Cox A, Curtin NJ, Dekker LVV, dos Santos Silva I, Duffy SW, Easton DF, Eccles DM, Edwards DR, Edwards J, Evans DG, Fenlon DF, Flanagan JM, Foster C, Gallagher WM, Garcia-Closas M, Gee JMW, Gescher AJ, Goh V, Groves AM, Harvey AJ, Harvie M, Hennessy BT, Hiscox S, Holen I, Howell SJ, Howell A,Hubbard G, Hulbert-Williams N, Hunter MS, Jasani B, Jones LJ, Key TJ, Kirwan CC, Kong A, Kunkler IH, Langdon SP, Leach MO, Mann DJ, Marshall JF, Martin LA, Martin SG, Macdougall JE, Miles DW, Miller MR, Morris JR, Moss SM, Mullan P, Natrajan R, O’Connor JPB, O’Connor R, Palmieri C, Pharoah PDP, Rakha EA, Reed E, Robinson SP, Sahai E, Saxton JM, Schmid P, Smalley MJ, Speirs V, Stein R, Stingl J, Streuli CH, Tutt ANJ, Velikova G, Walker RA, Watson CJ, Williams KJ, Young LS, Thompson AM. Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer. Breast Cancer Research. 2013;15(5):R92.

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