Recent advances in basic science have led to a better understanding of the molecular events important in the pathogenesis of breast cancer. Very little of this new knowledge, however, has had a significant impact on improving the diagnosis and therapy of breast cancer. We review many of the molecular events important in the pathogenesis of breast cancer, including inherited abnormalities in BRCA-1 and BRCA-2, p53, ATM, and PTEN and sporadic alterations in growth factors and their receptors, signal transduction, cell cycle control, DNA repair, cell death, angiogenesis, and invasion and metastasis. We suggest ways to speed up clinical applications of the new molecular knowledge base through the use of preclinical disease models, development of high throughput sample analysis and infrastructure programs to facilitate translational research, implementation of practice guidelines, and development of regional oncology networks. Only through the implementation of such a deliberate, multifaceted strategy will the gap between the research laboratory and the clinic be closed.