“…Because increasing evidence indicates a link among basal-like tumors, the stem cell phenotype, EMT and the acquisition of tumorigenic, invasive and metastatic potential, 63 and because breast stem cells have been shown to display a basal-like phenotype with an increased expression of EMT-related genes (e.g., SLUG/SNAIL2, VIM and N-cadherin), [64][65][66][67][68][69] it might be tempting to suggest that the primary resistance to trastuzumab in the basal/HER2 subtype can be explained in terms of an intrinsic enrichment of the CSCs with EMT features. Although this suggestion might appear counterintuitive, because trastuzumab-resistant basal/HER2 cells are positive for both markers (i.e., CD44 + CD24 + ) and because of the widely accepted CD44 + CD24 -/ low mesenchymal immunophenotype of breast CSCs, it should be noted that CD24 is dynamically regulated, as recently demonstrated by Meyer et al 46 When we previously explored how trastuzumab-refractory basal/HER2+ JIMT1 cells inherently regulated the CD44 + CD24 -/low surface markers, 12 we observed that the dynamic expression of the EMT-related markers was not limited to CD44/CD24, i.e., the number of cells bearing the CD44 + CD24 -/ low mesenchymal immunophenotype switched over time from 10% in early passages to 80% in late passages.…”