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Table 2 Summary of the gap analysis for the initiation of breast cancer

From: Evaluation of the current knowledge limitations in breast cancer research: a gap analysis

What do we know?

Animal models have given us great insight into the molecular pathways involved in breast development and dysregulation in cancer.

What are the gaps?

The relationship of signalling pathways to ductal and acinar breast architecture.

 

The need for widespread use of more appropriate in vivo and culture methods.

 

The importance of stroma and other cell types, cell adhesion and the extracellular matrix.

 

Understanding stem cells.

 

Understanding mechanisms of epithelial apoptosis.

 

Understanding how pregnancy and functional differentiation in the breast protect against breast cancer.

Problems

The breast cell lines used and their culture conditions.

 

A wider variety of promoters with spatial, temporal and differentiation control of gene expression is needed.

 

The need for mouse models of specific breast cancer types, for example, triple negative breast cancer.

 

The implantation methods for single cells in vivo.

Translational implications

Understanding the complex interactions between cell types should provide new opportunities for intervention.

 

Identifying pre-invasive changes has implications for patient-tailored approaches.

Recommendations

Develop three-dimensional cell culture models, containing multiple cell types, which reflect the tissue architecture of the normal and diseased breast.

 

Generate better animal models, in which gene expression can be manipulated in each cell type of the mammary gland and will not be altered by transdifferentiation or dedifferentiation.

 

Gain a greater understanding of the genetic changes that occur within atypias and DCIS.