Published online Dec 10, 2015. doi: 10.5306/wjco.v6.i6.207
Peer-review started: May 28, 2015
First decision: August 4, 2015
Revised: September 7, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: December 10, 2015
Processing time: 196 Days and 18.5 Hours
Breast cancer affects one in eight women around the world. Seventy five percent of these patients have tumors that are estrogen receptor positive and as a consequence receive endocrine therapy. However, about one third eventually develop resistance and cancer reappears. In the last decade our vision of cancer has evolved to consider it more of a tissue-related disease than a cell-centered one. This editorial argues that we are only starting to understand the role the tumor microenvironment plays in therapy resistance in breast cancer. The development of new therapeutic strategies that target the microenvironment will come when we clearly understand this extremely complicated scenario. As such, and as a scientific community, we have extremely challenging work ahead. We share our views regarding these matters.
Core tip: Resistance to endocrine therapy in breast cancer is an important clinical problem that requires further insight to develop a solution. We here discuss a paradigm shift, where the interplay of the tumor cells with the microenvironment, and the role of cancer stem cells are discussed as key targets in the development of novel therapeutic strategies.