REVIEW BackgroundBreast cancer is one of the most prevalent cancers in women worldwide [1,2] and is the most common cause of cancer deaths in women [2]. The deaths related to breast cancer are not due to the primary tumors, but are due to the metastases to the lungs, brain and bone [3,4]. Therefore, treatment and management to block metastases is an important target for therapy that would improve survival in breast cancer patients.Irregularities in cell adhesion play an important role in cancer progression and metastasis [5]. The Thomsen-Friedenreich antigen (TF-Ag) is the disaccharide, galactose-β1-3N-acetyl galactosamine (Galβ1-3GalNAc) α-O-linked to serine or threonine residues in glycoproteins [6]. It is a tumor-associated antigen, which is covered by other carbohydrate moieties and thus hidden in normal cells, but exposed in cancers such as breast, lung, prostate and bladder [6][7][8][9]. TF-Ag plays a role in cancer cell adhesion and metastasis as a result of interacting with lectins at metastatic sites [10,11]. One particular lectin that interacts with the TF-Ag to establish metastasis is galectin-3. This interaction may provide an explanation for the direct relationship between TF-Ag expression, galectin-3 expression and cancer metastasis and aggression, with patients having elevated galectin-3 levels and tumor cells bearing elevated TF-Ag levels having the most aggressive, metastatic cancers [11,12]. Previous studies proposed that TF-Ag and galectin-3 interaction with galectin-3 mobilization to the endothelial cell surface is involved in the first step of a two-step tumor cell-endothelial cell interaction for tumor adhesion and metastasis [10]. This step is followed by an integrin-mediated orders, please contact: reprints@futuremedicine.com