{"slug":"breast","tag":"breast","variants":["breast"],"description":"Breast cancers and the people who work on them.","count":42,"kinds":{"cancer":5,"person":37},"related":[{"slug":"trialist","tag":"trialist","shared":12},{"slug":"de-escalation","tag":"de-escalation","shared":9},{"slug":"adc","tag":"adc","shared":4},{"slug":"her2","tag":"her2","shared":4},{"slug":"radiotherapy","tag":"radiotherapy","shared":4},{"slug":"surgery","tag":"surgery","shared":4},{"slug":"genomics","tag":"genomics","shared":3},{"slug":"ai","tag":"ai","shared":2},{"slug":"biostatistics","tag":"biostatistics","shared":2},{"slug":"classification","tag":"classification","shared":2},{"slug":"prevention","tag":"prevention","shared":2},{"slug":"screening","tag":"screening","shared":2}],"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":"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":"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."}]}