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Meet Sandra O’Toole – Breast Cancer Researcher and Pathologist

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9th October, 2025

Breast Cancer Awareness Month in October is the perfect time to shine a spotlight on Professor Sandra O’Toole, who is working ahead of the curve to improve diagnosis and outcomes for breast cancer patients.

Pro­fes­sor O’Toole is a Senior Staff Spe­cial­ist in Tis­sue Pathol­o­gy and Diag­nos­tic Oncol­o­gy at Roy­al Prince Alfred Hos­pi­tal and Pro­fes­sor of Pathol­o­gy at the Uni­ver­si­ty of Sydney.

What moti­vates her to suc­ceed is also deeply per­son­al, because she was inspired to start her career in breast can­cer research after see­ing the ter­ri­ble impact breast can­cer had on her mother.

“Breast can­cer is the most com­mon can­cer affect­ing women, but with­in this large group there are rare and under­stud­ied tumour types that pose par­tic­u­lar chal­lenges for patients and clin­i­cians alike,” said Pro­fes­sor O’Toole.

Pro­fes­sor O’Toole has ded­i­cat­ed much of her research to under­stand­ing these uncom­mon can­cers, with a spe­cial focus on phyl­lodes tumours.

This week she will speak about phyl­lodes tumours and her research at the Aus­tralasian Soci­ety of Breast Dis­eases 14th Sci­en­tif­ic Meet­ing in Queensland.

“Phyl­lodes tumours are rare fibroep­ithe­lial breast tumours that can be dif­fi­cult to diag­nose and man­age, with a spec­trum rang­ing from benign to malignant”.

“Along with my col­lab­o­ra­tors, we have been at the fore­front of iden­ti­fy­ing mol­e­c­u­lar sig­na­tures that may help refine diag­no­sis, pre­dict tumour behav­iour, and guide more per­son­alised treat­ment,” she said.

Her work in this area is focused on devel­op­ing more reli­able tests and bet­ter out­comes for patients affect­ed by these chal­leng­ing cancers.

In addi­tion to her research on rare breast can­cers, Pro­fes­sor O’Toole is the lead pathol­o­gist for the Breast Can­cer Cell Atlas, an inter­na­tion­al ini­tia­tive led by her long-term col­lab­o­ra­tor Pro­fes­sor Alexan­der Swar­brick at the Gar­van Insti­tute that is using cut­ting-edge sin­gle-cell and spa­tial tech­nolo­gies to map the cel­lu­lar com­plex­i­ty of breast cancer.

Breast cancer cells that are pink under microscope.
Account­ing for less than 1% of breast tumours, phyl­lodes tumours can be dif­fi­cult to diag­nose due to their sim­i­lar­i­ty under the micro­scope to oth­er types of breast tumours. Most phyl­lodes tumours are benign, but 10% are malig­nant. Accu­rate diag­no­sis is cru­cial for effec­tive treat­ment, as mis­di­ag­no­sis results in inap­pro­pri­ate or delayed treatment.

In addi­tion to her research on rare breast can­cers, Pro­fes­sor O’Toole is the lead pathol­o­gist for the Breast Can­cer Cell Atlas, an inter­na­tion­al ini­tia­tive led by her long-term col­lab­o­ra­tor Pro­fes­sor Alexan­der Swar­brick at the Gar­van Insti­tute that is using cut­ting-edge sin­gle-cell and spa­tial tech­nolo­gies to map the cel­lu­lar com­plex­i­ty of breast cancer .

“This project brings togeth­er researchers, clin­i­cians, and patients to gen­er­ate the most com­pre­hen­sive view of breast can­cer at the sin­gle cell and spa­tial lev­el to date. The atlas is already reveal­ing how dif­fer­ent cell pop­u­la­tions inter­act with­in tumours and how this shapes dis­ease pro­gres­sion and treat­ment response,” Pro­fes­sor O’Toole said.

Pro­fes­sor O’Toole said one of the most reward­ing aspects of her research is that is so close­ly tied to her diag­nos­tic work as part of a mul­ti­dis­ci­pli­nary team at Roy­al Prince Alfred Hos­pi­tal and The Chris O’Brien Lifehouse.

“The dai­ly diag­nos­tic chal­lenges inform the direc­tion of my research and I’m so grate­ful for the enthu­si­as­tic sup­port of my clin­i­cal col­leagues. Our col­lab­o­ra­tions real­ly facil­i­tate the efforts to improve diag­no­sis and out­comes for breast can­cer patients.

“I get a lot of joy from work­ing with a great team of sci­en­tists, med­ical and sur­gi­cal can­cer spe­cial­ists. Togeth­er we’re tack­ling the chal­lenges from all angles using basic and clin­i­cal sci­ence to find the right answers.”

In addi­tion to her valu­able work done in NSW Health Pathol­o­gy and research, Pro­fes­sor O’Toole is stand­ing for Pres­i­dent of the Roy­al Col­lege of Pathol­o­gists of Aus­trala­sia (RCPA), with elec­tions to be held this month.

We wish her all the best in her endeav­ours to shape the future of the profession!

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