This paper describes our study of the impact of precision tests on treatment planning for breast cancer patients. We showed that molecular testing results in a change in treatment recommendation for a significant proportion of patients and often allows them to avoid damaging chemotherapies. The study established the need for an affordable precision test that can be made universally available in Australia.

Phuong Dinh, J. Dinny Graham, Elisabeth N. Elder, Masrura Kabir, Tram B. Doan, James French, Farid Meybodi, Rina Hui, Nicholas R. Wilcken, Paul R. Harnett, Jeremy Hsu, Kirsty E. Stuart, Tim Wang, Verity Ahern, Meagan Brennan, Stephen B. Fox, Rachel F. Dear, Elgene Lim, Michelle White, G. Bruce Mann & Nirmala Pathmanathan

The mineralocorticoid receptor is in the same family of nuclear receptors as the estrogen and progesterone receptors that have particular importance in breast cancer. In this study we showed that it acts as a tumour suppressor by interacting with vitamin A signalling pathways to change tumour metabolism. Tram B. Doan, Vanessa Cheung, Colin D. Clyne, Heidi N. Hilton, Natalie Eriksson, Morag J. Young, John W. Funder, George E. O. Muscat, Peter J. Fuller, Christine L. Clarke & J. Dinny Graham

Neoadjuvant chemotherapy has become standard of care for locally advanced estrogen receptor (ER) negative breast cancer. However, the evidence for benefit to ER positive disease is weak and neoadjuvant endocrine treatment is under-utilized as an alternative. This systematic study showed neoadjuvant endocrine treatment is superior to chemotherapy for neoadjuvant treatment of ER positive breast cancer and defined the ideal duration and level of treatment. Lauren I. Madigan, Phuong Dinh and J. Dinny Graham

doi: https://doi.org/10.1186/s13058-020-01314-6

Using artificial intelligence and automated digital image analysis of triple negative breast tumour tissues, we developed novel algorithms that can recognise features that predict disease prognosis, which are not evident to a human observer. Rawan Albusayli, J Dinny Graham, Nirmala Pathmanathan, Muhammad Shaban, Shan E Ahmed Raza, Fayyaz Minhas, Jane E Armes, Nasir Rajpoot

doi: http://doi.org/10.1002/path.6061

This comprehensive review of the changes that occur as in situ malignancy in the breast progresses to become invasive, was the feature article highlighted on the cover of the Journal of Mammary Gland Biology and Neoplasia when it was published. The work inspired our multiplexed spatial mapping of ductal carcinoma in situ tissues that revealed key changes that could be used to predict invasive progression. Gemma M. Wilson, Phuong Dinh, Nirmala Pathmanathan, J. Dinny Graham

doi: https://doi.org/10.1007/s10911-022-09517-7