Known genetic mutations and familial hereditary factors account for less than 20-25% of breast cancer cases in women, therefore, most instances have been classified as sporadic cases of unknown aetiologies. Single nucleotide polymorphisms (SNPs) were considered as breast cancer risk factors, but numerous studies have failed to support this assertion. Recent evidence correlates aberrant epigenetic mechanisms in the development and metastatic progression of breast cancer, yet there has been limited progress made to identify the primary aetiology underlying sporadic cases of breast cancer. This has led some researchers to consider alternative hypotheses including in utero exposure to deleterious chemical agents during early development, the immortal strand and the strand-specific imprinting and selective chromatid segregation hypotheses. Here, we integrate prominent alternate models to help guide future research on this very important topic concerning human health. The aetiology of cancer, including breast cancer, is often discussed in the context of genetic and environmental risk factors. Skin cancer is the major class of cancer that occurs both in men and women and its risk factor is predominantly considered to be environmental exposure to sun. On the other hand, genetic risk factors are considered key to the development of breast cancer, the second most common cancer, accounting for nearly one in three cases diagnosed in United States women [1]. The American Cancer Society lists some of the perils in breast cancer as non-modifiable, such as gender (women account for ~99% of the cases), race (Caucasian women have the highest risk), early menses (increased risk if menses begin <12 years age), and increased risk with age. Others are modifiable factors-use of oral contraceptives, hormone replacement therapy, obesity, and use of alcohol-all of which contribute to increased risk of breast cancer. Even though BRCA1 and BRCA2 account for the majority of genetic mutations found in breast cancer cases, only 5-10% of breast cancer cases result directly from specific gene mutations. Another 15-20% of cases are considered to be familial, such that a cluster of cancers affects first-or second-degree relatives, but with an unclear inheritance pattern [2]. The majority of breast cancer cases are termed "sporadic" cancers, with apparently no known cause; however researchers have suggested numerous possibilities over the past several decades. Here we provide an overview of the progression of ideas proposed for explaining the cause of breast cancer, followed by our perspective aimed at suggesting an aetiology that integrates some of the more plausible concepts.According to the American Society of Clinical Oncology, autosomal dominant mutations of the BRCA1 and BRCA2 genes with low penetrance act as predisposing factors for hereditary breast/ovarian cancer (HBOC); that is, not all subjects carrying disease susceptibility mutations even in homozygous conditions develop disease. These mutations are also associated with an inc...