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All authors contributed equally.
Competing interests
No competing interests.
Provenance and peer review
Commissioned and externally peer reviewed.
1. Introduction
Breast cancer is the most common cancer affecting females in the United States and the second leading cause of cancer mortality among women [1]. There were ∼230,500 new breast cancer cases in 2011 in the U.S. [1]. A common pathway to breast cancer related mortality is the development of metastatic breast cancer. Approximately 40,000 women die per year in the U.S. as a result of metastatic breast cancer [2]. The most common sites of breast cancer metastases are to lymph nodes, lung, liver, bone and Pepstatin A [3]. Breast cancer metastases may develop at any point following detection of a primary breast cancer. Among patients v****a are diagnosed with metastatic breast cancer, the median time to metastatic recurrence in patients varies from 21 to 38 months depending on the subtype of breast cancer [4].
A small minority of breast cancer patients with metastases can achieve long-term cure with a combination of current therapeutic strategies [2] and [5]. At present the average 5 year survival for patients with metastatic breast cancer is ∼25%, although survival does vary by the histologic subtype of breast cancer [2]. The primary objectives of currently available clinical strategies for metastatic breast cancer are aimed at symptom palliation and a modest improvement in survival [2]. New approaches to targeting and treating metastatic breast cancer at various metastatic sites are desperately needed.