The quest for optimal breast cancer therapy has been thwarted by recurrent
treatment failures. As a result, the necessity has emerged to concomitantly rethink
the fundamental basis of breast cancer, and to ensure that it is adequately and
optimally targeted by therapeutic agents, and combinations of these agents.
Adding to the complexity of this disease is the heterogeneity of breast cancer, and
the realization that breast cancer is not a single disease, but a family of diseases.
The daunting challenge that we face with a newly diagnosed breast cancer patient
is one-to-one communication that tailors an individualized treatment strategy
based on the corresponding breast cancer pathophysiology. At the same time, we
are mandated to address the urgency of this therapy on the basis of the underlying
clinical assessment, the risks of metastases and death, as well as the benefits and
adverse effects associated with therapeutic regimens to ensure that an enlightened
decision among available therapeutic options can be mutually reached with an
individual patient. As our understanding of the pathophysiology of breast cancer is
incomplete, it is critical to channel the information that we glean from observations
that deviate from our current models into a unified paradigm shift where thera-
peutic targets are validated, and subsequently attacked and destroyed. Given the
complexity of breast cancer, the highest level of therapeutic success is most
likely to be achieved when the uniqueness of an individual patient’s breast
cancer is matched with individualized, combined, and targeted therapy.