Massive advances in understanding breast cancer have still left major gaps in knowledge, experts warned today.
These include the extent of the genetic changes that take place as the disease progresses.
The British experts say their analysis could help map out new paths for researching the disease, which is now recognised as several different kinds of cancer.
One expert says the analysis could lead to immediate changes in practice – as doctors may not take biopsies when the disease becomes metastatic.
The analysis is published in the journal Breast Cancer Research.
As well as the study of genetic changes, the researchers say there needs to be more study of "sustainable" lifestyle changes that may help patients through diet, exercise and weight management.
And they call for more research into how to identify the best treatment for personalised therapy.
Professor Sue Eccles, of the Institute of Cancer Research, London, said: "We now know that breast cancer cells can have different characteristics, even within the same tumour, and these can also change over time.
"This makes it much more complex to research and is why we need greater collaboration between multi-disciplinary teams and an improved infrastructure, to ensure we are getting the data and tissue samples needed to advance our research knowledge.”
Fellow author Professor Alastair Thompson, of the University of Dundee, Scotland, said the analysis gave "scientific rationale" to change some clinical practice.
He said: "For example, currently, metastatic disease is not biopsied in order to tailor treatment, but this could change the way one in six women are treated and provide hope to women with secondary breast cancer, with limited treatment options.”
Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer. Breast Cancer Research 1 October 2013; 15:R92
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