Multistep tumorigenesis and the mircroenvironment

Pepper Schedin, Anthony Elias

Research output: Contribution to journalReview articlepeer-review

82 Scopus citations


Early-stage cancers have long been considered to be less aggressive than late-stage cancers because it is assumed that they have accumulated fewer of the mutations that are required for full metastatic potential. For breast cancer, recent gene expression profiling data have challenged this paradigm by identifying early-stage cancers with similar gene expression profiles to fully metastatic cancers. In this review, multistep carcinogenesis is reconsidered in light of these new data. The concept that the tumor stroma plays a key role in determining whether a metastatic tumor cell will remain dormant or become invasive is discussed. Recent studies demonstrating the feasibility of targeting tumor stroma for cancer prevention and treatment are presented.

Original languageEnglish (US)
Pages (from-to)93-101
Number of pages9
JournalBreast Cancer Research
Issue number2
StatePublished - Mar 2004
Externally publishedYes


  • Breast cancer
  • Metastasis
  • Microenvironment
  • Multistep carcinogenesis
  • Reactive stroma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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