For example, HMGB1 induces a retinoblastoma protein-dependent G1 cell-cycle arrest in breast cancer, thus functioning as a tumour suppressor protein and inducer of apoptosis.53 However, these cellular mechanistic studies in human tissue are challenged by a lack of access to fresh tissue given changes in clinical practice with increasing oncological focus on treatment of cancer and endoscopic resection of early lesions, with oesophagectomy rarely performed outside tertiary centres. This evidence concerns the gene HMGB1 and breast cancer.