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The Life History of 21 Breast Cancers
Open accessAbstract
Cancer evolves dynamically as clonal expansions supersede one another driven by shifting selective pressures, mutational processes, and disrupted cancer genes. These processes mark the genome, such that a cancer's life history is encrypted in the somatic mutations present. We developed algorithms to decipher this narrative and applied them to 21 breast cancers. Mutational processes evolve across a cancer's lifespan, with many emerging late but contributing extensive genetic variation. Subclonal diversification is prominent, and most mutations are found in just a fraction of tumor cells. Every tumor has a dominant subclonal lineage, representing more than 50% of tumor cells. Minimal expansion of these subclones occurs until many hundreds to thousands of mutations have accumulated, implying the existence of long-lived, quiescent cell lineages capable of substantial proliferation upon acquisition of enabling genomic changes. Expansion of the dominant subclone to an appreciable mass may therefore represent the final rate-limiting step in a breast cancer's development, triggering diagnosis.
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![Figure S7 Patterns of Subclonal Mutation in 20 Breast Cancer Genomes, Related to Figure 6 (A) Fitted three-parameter logistic curves to bootstrapped estimates of sensitivity for mutations at different levels of subclonality derived from each of the 20 breast cancer genomes. For the five samples colored blue the raw bootstrapped values are shown (as plus [+] symbols), to allow assessment of goodness-of-fit of the logistic curve to the raw data. (B) Comparison of the empiric distributions of subclonal mutations between PCR with deep pyrosequencing on the 454 platform and exome pull-down and sequencing for four patients. For each histogram, point mutations called in the original whole-genome sequencing were identified for which there was independent validation by either 454 sequencing or exome pull-down. The distributions of subclonality obtained from each validation method are then plotted in the relevant histogram. (C) Statistical modeling by a Bayesian Dirichlet process of the distribution of clonal and subclonal mutations for 16 breast cancers. The empiric histogram of mutations is shown in pale blue, with the fitted distribution as a dark green line. Also shown are the 95% posterior confidence intervals for the fitted distribution (pale green area).](/paper-figures/465df46d5eaa40d6a6bd90cd52ef6ced/the-life-history-of-21-breast-cancers-figure-15.jpg)

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“Cancer whole genome sequencing (WGS) is now feasible, with thousands of matched tumor-normal pairs successfully sequenced to date, revealing novel biological insights2–4.”
From Whole-genome sequencing of triple-negative breast cancers in a population-based clinical study (2019) · cites this paper as [3]
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Metadata
- Authors
- Nik-Zainal, S., Van Loo, P., Wedge, D. C., Alexandrov, L. B., Greenman, C. D., Lau, K. W., Raine, K., Jones, D., Marshall, J., Ramakrishna, M., Shlien, A., Cooke, S. L., Hinton, J., Menzies, A., Stebbings, L. A., Leroy, C., Jia, M., Rance, R., Mudie, L. J., Gamble, S. J., Stephens, P. J., McLaren, S., Tarpey, P. S., Papaemmanuil, E., Davies, H. R., Varela, I., McBride, D. J., Bignell, G. R., Leung, K., Butler, A. P., Teague, J. W., Martin, S., Jönsson, G., Mariani, O., Boyault, S., Miron, P., Fatima, A., Langerød, A., Aparicio, S. A. J. R., Tutt, A., Sieuwerts, A. M., Borg, Å., Thomas, G., Salomon, A. V., Richardson, A. L., Børresen-Dale, A.-L., Futreal, P. A., Stratton, M. R., & Campbell, P. J.
- Affiliations
- Wellcome Sanger Institute (GB)
- University of East Anglia (GB)
- King's College London (GB)
- Institut Curie (FR)
- Lyon 1 Université (FR)
- Dana-Farber Cancer Institute (US)
- Oslo University Hospital (NO)
- University of British Columbia (CA)
- Erasmus MC (NL)
- Lund University (SE)
- Brigham and Women's Hospital (US)
- University of Cambridge (GB)
- Corresponding author
- Campbell, Peter J.
- ORCID
- Wedge, David C.
- Alexandrov, Ludmil B.
- Lau, King Wai
- Raine, Keiran
- Jones, David
- Marshall, John
- Ramakrishna, Manasa
- Shlien, Adam
- Hinton, Jonathan
- Menzies, Andrew
- Jia, Mingming
- Tarpey, Patrick S.
- Papaemmanuil, Elli
- Davies, Helen R.
- Varela, Ignacio
- McBride, David J.
- Teague, Jon W.
- Martin, Sancha
- Jönsson, Goran
- Mariani, Odette
- Boyault, Sandrine
- Miron, Penelope
- Aparicio, Samuel A.J.R.
- Tutt, Andrew
- Sieuwerts, Anieta M.
- Borg, Åke
- Thomas, Gilles
- Richardson, Andrea L.
- Futreal, P. Andrew
- Stratton, Michael R.
- Campbell, Peter J.
- Venue
- Cell
- Publisher
- Elsevier BV
- Published
- 2012-05
- Volume
- 149
- Issue
- 5
- Pages
- 994-1007
- ISSN
- 0092-8674 (ISSN-L)
- PMC
- PMC3428864
- OpenAlex
- W2109991075
- Cited by
- 1,443
- References
- 39
- Citations by year
- 2026: 51 · 2025: 77 · 2024: 83 · 2023: 84 · 2022: 71 · 2021: 112 · 2020: 105 · 2019: 93 · 2018: 114 · 2017: 103 · 2016: 100 · 2015: 126 · 2014: 139 · 2013: 140 · 2012: 44
- FWCI
- 47.68
- Type
- journal article
- Language
- en
- Update notices
- erratum (2015-08-13)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Cell (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Lirias (KU Leuven) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- Wellcome Trust (088340, 093867, WT088340MA, 098051)
- National Institute for Health and Care Research
- European Commission (242006)
- National Cancer Institute (CA 089393, P50CA089393)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Single-cell and spatial transcriptomics
- Keywords
- breast cancer, tumor evolution, clonal evolution, somatic mutations, mutational processes, clonal expansion, cancer genomics
- MeSH terms
- Algorithms, Breast Neoplasms, Cell Transformation, Neoplastic, Chromosome Aberrations, Female, Humans, Mutation, Point Mutation, Clonal Evolution
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