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We describe a new method based on principal component analysis and robust consensus ensemble clustering to identify and elucidate the subtypes of breast cancer disease. The method was applied to microarray gene expression data using micro-dissection of samples from 36 breast cancer patients with at least two of three pathological stages of disease. Controls were normal breast epithelial cells from 3 disease free patients. Our method identified an optimum set of genes and strong, stable clusters which correlated well with clinical classification into Luminal, Basal and Her2+ subtypes based on ER, PR and Her2 status. It also revealed a hierarchical portrait of disease progression through various grades and stages and identified genes and functional pathways for each stage, grade and disease subtype. We found that gene expression heterogeneity across subtypes is much greater than the heterogeneity of progression from DCIS to IDC within a subtype, suggesting that the disease subtypes are distinct disease processes. The averaging over data perturbations and clustering methods is critical in the robust identification of subtypes and gene markers for grade and progression.

High-throughput gene expression profiling can identify sets of genes that are differentially expressed between different phenotypes. Discovering marker genes is particularly important in diagnosis of a cancer phenotype. However, gene sets produced to date are too large to be economically viable diagnostics. We use a hybrid decision tree-discriminant analysis to identify small sets of genes, i.e. single genes and gene pairs, which separate normal samples from different stages of tumor samples. Half the samples are selected for training to form the probability distribution of expression values of each gene. The distributions for the tumor and normal phenotypes are then used to classify the test samples. The algorithm also identifies gene pairs by combining the probability distributions to construct a decision tree which is used to determine the class of test samples. After a series of training and testing sessions, genes and gene pairs that classify all samples correctly are recorded. The method was applied to a breast cancer data; and classifier genes that distinguish normal breast from different stages of breast tumor were identified. The genes were ranked according to their minimum Euclidean distance between the expression values in tumor and normal samples. The algorithm was able to pick known cancer related genes but also find genes that were not identified as differentially expressed by t-test with a 2 fold cut-off. Overall, the method generates possible diagnostic genes and gene pairs for a specific disease phenotype to pursue further biological interpretations in cancer biology.