EMT is a pre-requisite for metastatic dissemination in majority of carcinomas, is characterised by a shift to SNAIL, ZEB and TWIST transcriptional activity, TGFβ and Wnt signaling and matrix metalloproteinase activity and results in repression of epithelial marker expression and “metaplastic” conversion to a motile mesenchymal phenotype [10]. The gene discussed is TWIST1; the disease is carcinoma.