Intratumoral Heterogeneity in Patients with Breast Cancer

May 15, 2013
Debu Tripathy, MD

Debu Tripathy, MD, Co-Leader, Women's Cancer Program, Norris Comprehensive Cancer Center, University of Southern California, describes intratumoral heterogeneity in patients with breast cancer.

Debu Tripathy, MD, Co-Leader, Women's Cancer Program, Norris Comprehensive Cancer Center, University of Southern California, describes intratumoral heterogeneity in patients with breast cancer.

Previously, tumors and their metastases were thought to be clonal and it was unknown that they could change over time as there were limited ways to analyze a tumor: with proteins, large segments of DNA, and DNA deletions.

Today, with the development of more discriminating techniques such as whole genome sequencing, protein arrays, and RNA arrays, oncologists are observing intratumoral heterogeneity. This notion makes sense, Tripathy says, as a tumor is essentially a microecosystem with cells vying to survive. It has become routine practice to obtain a biopsy of a tumor's metastases to confirm that it is cancerous and also to recheck biomarkers.

Clinical Pearls

  • With the development of more discriminating techniques, there is now a greater understanding of intratumoral heterogeneity
  • A tumor is essentially a microecosystem with cells competing to survive
  • It has become routine practice to biopsy a disease's metastases