“…It is especially important, as underlined by Jones and White in their invited perspective 11 accompanying the article by Kay et al., that further research be done to clarify the role of environmental exposures in the etiology of estrogen receptor–negative tumors, a highly aggressive breast cancer that is mostly diagnosed in young women. 12 We agree with Jones and White that improving prevention efforts is fundamental, and such efforts could also focus on metastatic dissemination as secondary prevention for breast cancer patients and survivors.…”