Clinical Professor Sandra O'Toole

Clinical Professor
Medicine, Central Clinical School

C39 - Royal Prince Alfred Hospital
The University of Sydney
NSW 2006 Australia

T: 95157182
F: 951558405

Biographical details

Research interests

My research interest focuses on markers of breast cancer recurrence or progression in human tissues. I also have an interest in developmental pathways as potential novel therapeutic targets in breast cancer.

I am passionate about the translation of research into clinical practice, reflected in my clinical role as a molecular pathologist, integrating cutting edge technologies into the hospital setting. Much of my recent research concentrates on the application of molecular pathology to guide patient diagnosis and treatment selection.

Teaching areas

I currently supervise a number of honours, masters and a PhD student.


Breast cancer; Melanoma and skin cancer; Lung cancer

International links

United States. (University of Ohio) Prof Tsonwin Hai Professor College of Medicine.
United States. (McGill University Canada) Prof William Muller.


2014 | 2013 | 2012 | 2011 | 2010 | 2009


  • Menzies, A., Lum, T., Wilmott, J., Hyman, J., Kefford, R., Thompson, J., O'Toole, S., Long, G., Scolyer, R. (2014), Intrapatient Homogeneity of BRAFV600E Expression in Melanoma. The American Journal of Surgical Pathology. 38(3), 377-382. [Abstract]
  • Gibbings, K., Warrier, S., Hwang, S., Rice, M., O'Toole, S., Carmalt, H. (2014), A giant phyllodes tumour with sepsis. ANZ Journal of Surgery. 84(11), 886-887. [Abstract]
  • Nair, R., Roden, D., Teo, W., McFarland, A., Junankar, S., Ye, S., Nguyen, A., Yang, J., Nikolic, I., Hui, M., Morey, A., Shah, J., Pfefferle, A., Usary, J., Selinger, C., Baker, L., Armstrong, N., Cowley, M., Naylor, M., Ormandy, C., Lakhani, S., Herschkowitz, J., Perou, C., Kaplan, W., O'Toole, S., Swarbrick, A. (2014), c-Myc and Her2 cooperate to drive a stem-like phenotype with poor prognosis in breast cancer. Oncogene. 333(30), 3992-4002. [Abstract]
  • Houang, M., Sioson, L., Clarkson, A., Watson, N., Farzin, M., Toon, C., Raut, A., O'Toole, S., Cooper, W., Pavlakis, N., Mead, S., Chou, A., Gill, A. (2014), EGFR mutation specific immunohistochemistry is a useful adjunct which helps to identify false negative mutation testing in lung cancer. Pathology. 46(6), 501-508. [Abstract]
  • Carlino, M., Haydu, L., Kakavand, H., Menzies, A., Hamilton, A., Yu, B., Ng, C., Cooper, W., Thompson, J., Kefford, R., O'Toole, S., Scolyer, R., Long, G. (2014), Correlation of BRAF and NRAS mutation status with outcome, site of distant metastasis and response to chemotherapy in metastatic melanoma. British Journal of Cancer. 111(2), 292-299. [Abstract]
  • Grey, A., Cooper, A., McNeil, C., O'Toole, S., Thompson, J., Grimison, P. (2014), Progression of KRAS mutant pancreatic adenocarcinoma during vemurafenib treatment in a patient with metastatic melanoma. Internal Medicine Journal. 44(6), 597-600. [Abstract]
  • Houang, M., Toon, C., Clarkson, A., Sioson, L., Watson, N., Farzin, M., Selinger, C., Chou, A., Morey, A., Cooper, W., O'Toole, S., Gill, A. (2014), Reflex ALK immunohistochemistry is feasible and highly specific for ALK gene rearrangements in lung cancer. Pathology. 46(5), 383-388. [Abstract]
  • Cooper, W., Fox, S., O'Toole, S., Morey, A., Frances, G., Pavlakis, N., O'Byrne, K., Dettrick, A., Leong, T., Rathi, V., Spagnolo, D., Hemmings, C., Singh, M., Moffat, D., Tsao, M., Wilner, K., Buller, R., Pitman Lowenthal, S., Arifeen, S., Binko, J., Alam, M. (2014), National Working Group Meeting on ALK diagnostics in lung cancer. Asia-Pacific Journal of Clinical Oncology. 10(Suppl 2), 11-17. [Abstract]
  • Kakavand, H., Crainic, O., Lum, T., O'Toole, S., Kefford, R., Thompson, J., Wilmott, J., Long, G., Scolyer, R. (2014), Concordant BRAFV600E mutation status in primary melanomas and associated naevi: implications for mutation testing of primary melanomas. Pathology. 46(3), 193-198. [Abstract]
  • Nguyen, N., Hampartzoumian, T., Cameron, B., Palmer, C., O'Toole, S., Post, J., Zekry, A., Lloyd, A. (2014), Regulation of T cell recruitment and inflammation in the human immunodeficiency virus/hepatitis C virus coinfected liver. Journal of Gastroenterology and Hepatology. 29(7), 1535-1543.
  • O'Toole, S., Yu, B., Cooper, W. (2014), Molecular Diagnosis in Cytology and Its Place in the New Classification: A Practical Guide. The Journal of OncoPathology. 2(1), 63-73.


  • Klein, O., Clements, A., Menzies, A., O'Toole, S., Kefford, R., Long, G. (2013), BRAF inhibitor activity in V600R metastatic melanoma. European Journal of Cancer. 49(5), 1073-1079. [Abstract]
  • Cooper, W., Lam, D., O'Toole, S., Minna, J. (2013), Molecular biology of lung cancer. Journal of Thoracic Disease. 5(Suppl 5), S479-S490. [Abstract]
  • Browne, B., Hochgrafe, F., Wu, J., Millar, E., Barraclough, J., Stone, A., McCloy, R., Lee, C., Roberts, C., Ali, N., Boulghourjian, A., Schmich, F., Linding, R., Farrow, L., Gee, J., Nicholson, R., O'Toole, S., Sutherland, R., Musgrove, E., Butt, A., Daly, R. (2013), Global characterization of signalling networks associated with tamoxifen resistance in breast cancer. The FEBS Journal. 280(21), 5237-5257. [Abstract]
  • Schade, B., Lesurf, R., Sanguin-Gendreau, V., Bui, T., Deblois, G., O'Toole, S., Millar, E., Zardawi, S., Lopez-Knowles, E., Sutherland, R., Giguère, V., Kahn, M., Hallett, M., Muller, W. (2013), Beta-Catenin Signaling is a Critical Event in ErbB2-Mediated Mammary Tumor Progression. Cancer Research. 73(14), 4474-4487. [Abstract]
  • Tran, T., Selinger, C., Kohonen-Corish, M., McCaughan, B., Kennedy, C., O'Toole, S., Cooper, W. (2013), Fibroblast growth factor receptor 1 (FGFR1) copy number is an independent prognostic factor in non-small cell lung cancer. Lung Cancer. 81(3), 462-467. [Abstract]
  • Cooper, W., Yu, B., Yip, P., Ng, C., Lum, T., Farzin, M., Trent, R., Mercorella, B., Clarkson, A., Kohonen-Corish, M., Horvath, L., Kench, J., McCaughan, B., Gill, A., O'Toole, S. (2013), EGFR mutant-specific immunohistochemistry has high specificity and sensitivity for detecting targeted activating EGFR mutations in lung adenocarcinoma. Journal of Clinical Pathology. 66(9), 744-748. [Abstract]
  • Selinger, C., Rogers, T., Russell, P., O'Toole, S., Yip, P., Wright, G., Wainer, Z., Horvath, L., Boyer, M., McCaughan, B., Kohonen-Corish, M., Fox, S., Cooper, W., Solomon, B. (2013), Testing for ALK rearrangement in lung adenocarcinoma: a multicenter comparison of immunohistochemistry and fluorescent in situ hybridization. Modern Pathology. 26(12), 1545-1553. [Abstract]
  • Rakha, E., O'Toole, S., Ellis, I., Tan, P. (2013), Breast pathology today: morphology and molecules. Journal of clinical pathology. 66, 457. [Abstract]
  • Cooper, C., O'Toole, S., Kench, J. (2013), Classification, morphology and molecular pathology of premalignant lesions of the pancreas. Pathology. 45(3), 286-304. [Abstract]
  • Yip, P., Yu, B., Cooper, W., Selinger, C., Ng, C., Kennedy, C., Kohonen-Corish, M., McCaughan, B., Trent, R., Boyer, M., Kench, J., Horvath, L., O'Toole, S. (2013), Patterns of DNA Mutations and ALK Rearrangement in Resected Node Negative Lung Adenocarcinoma. Journal of Thoracic Oncology. 8(4), 408-414. [Abstract]
  • Hui, M., Cazet, A., Nair, R., Watkins, D., O'Toole, S., Swarbrick, A. (2013), The Hedgehog signalling pathway in breast development, carcinogenesis and cancer therapy. Breast Cancer Research. 15(2), 203. [Abstract]
  • Klein, O., Clements, A., Menzies, A., O'Toole, S., Kefford, R., Long, G. (2013), BRAF inhibitor activity in V600R metastatic melanoma - Response. European Journal of Cancer. , 1797-1798. [Abstract]
  • O'Toole, S., Beith, J., Millar, E., West, R., McLean, A., Cazet, A., Swarbrick, A., Oakes, S. (2013), Therapeutic targets in triple negative breast cancer. Journal of Clinical Pathology. 66(6), 530-542. [Abstract]
  • Karim, R., O'Toole, S., Scolyer, R., Cooper, C., Chan, B., Selinger, C., Yu, B., Carmalt, H., Mak, C., Tse, G., Tan, P., Putti, T., Lee, C. (2013), Recent insights into the molecular pathogenesis of mammary phyllodes tumours. Journal of Clinical Pathology. 66, 496-505. [Abstract]
  • Shields, B., Wiede, F., Gurzov, E., Wee, K., Hauser, C., Zhu, H., Molloy, T., O'Toole, S., Daly, R., Sutherland, R., Mitchell, C., McLean, C., Tiganis, T. (2013), TCPTP regulates SFK and STAT3 signaling and is lost in triple-negative breast cancers. Molecular and Cellular Biology. 33(3), 557-570. [Abstract]
  • Cooper, C., Karim, R., Selinger, C., Carmalt, H., Lee, C., O'Toole, S. (2013), Molecular alterations in metaplastic breast carcinoma. Journal of Clinical Pathology. 66(6), 522-528. [Abstract]
  • Cooper, W., O'Toole, S. (2013), Molecular Pathology in lung Cancer. Cancer Forum. 37(2), 1-7.
  • Saunderson, R., Garsia, R., Headley, A., McCaughan, G., O'Toole, S., Strasser, S. (2013), Pentoxifylline-induced drug rash with eosinophilia and systemic symptoms (DRESS) in a patient with caffeine intolerance. Journal of Dermatological Case Reports. 7(3), 77-81. [Abstract]


  • Coates, A., Millar, E., O'Toole, S., Molloy, T., Viale, G., Goldhirsch, A., Regan, M., Gelber, R., Sun, Z., Castiglione-Gertsch, M., Gusterson, B., Musgrove, E., Sutherland, R. (2012), Prognostic interaction between expression of p53 and estrogen receptor in patients with node-negative breast cancer: results from IBCSG Trials VIII and IX. Breast Cancer Research. 14(6), R143. [Abstract]


  • Roberts, C., Millar, E., O'Toole, S., McNeil, C., Lehrbach, G., Pinese, M., Tobelmann, P., McCloy, R., Musgrove, E., Sutherland, R., Butt, A. (2011), Identification of PUMA as an estrogen target gene that mediates the apoptotic response to tamoxifen in human breast cancer cells and predicts patient outcome and tamoxifen responsiveness in breast cancer. Oncogene. 30(28), 3186-97. [Abstract]
  • Millar, E., Graham, P., McNeil, C., Browne, L., O'Toole, S., Boulghourjian, A., Kearsley, J., Papadatos, G., Delaney, G., Fox, C., Nasser, E., Capp, A., Sutherland, R. (2011), Prediction of outcome of early ER+ breast cancer is improved using a biomarker panel, which includes Ki-67 and p53. British journal of cancer. 105(2), 272-80. [Abstract]
  • O'Toole, S., Machalek, D., Shearer, R., Millar, E., Nair, R., Schofield, P., McLeod, D., Cooper, C., McNeil, C., McFarland, A., Nguyen, A., Ormandy, C., Qiu, M., Rabinovich, B., Martelotto, L., Vu, D., Hannigan, G., Musgrove, E., Christ, D., Sutherland, R., Watkins, D., Swarbrick, A. (2011), Hedgehog Overexpression Is Associated with Stromal Interactions and Predicts for Poor Outcome in Breast Cancer. Cancer Research. 71(11), 4002-4014. [Abstract]
  • O'Toole, S., Selinger, C., Millar, E., Lum, T., Beith, J. (2011), Molecular assays in breast cancer pathology. Pathology. 43(2), 116-127. [Abstract]
  • Cooper, W., O'toole, S., Boyer, M., Horvath, L., Mahar, A. (2011), What's new in non-small cell lung cancer for pathologists: the importance of accurate subtyping, EGFR mutations and ALK rearrangements. Pathology. 43(2), 103-115. [Abstract]
  • Xu, H., Yan, M., Patra, J., Natrajan, R., Yan, Y., Swagemakers, S., Tomaszewski, J., Verschoor, S., Millar, E., van der Spek, P., Reis-Filho, J., Ramsay, R., O'Toole, S., McNeil, C., Sutherland, R., McKay, M., Fox, S. (2011), Enhanced RAD21 cohesin expression confers poor prognosis and resistance to chemotherapy in high grade luminal, basal and HER2 breast cancers. Breast cancer research : BCR. 13(1), R9. [Abstract]
  • Colvin, E., Susanto, J., Kench, J., Ong, V., Mawson, A., Pinese, M., Chang, D., Rooman, I., O'Toole, S., Segara, D., Musgrove, E., Sutherland, R., Apte, M., Scarlett, C., Biankin, A. (2011), Retinoid signaling in pancreatic cancer, injury and regeneration. PloS One. 6(12), e29075. [Abstract]
  • Chan, P., Möller, A., Liu, M., Sceneay, J., Wong, C., Waddell, N., Huang, K., Dobrovic, A., Millar, E., O'Toole, S., McNeil, C., Sutherland, R., Bowtell, D., Fox, S. (2011), The expression of the ubiquitin ligase SIAH2 (seven in absentia homolog 2) is mediated through gene copy number in breast cancer and is associated with a basal-like phenotype and p53 expression. Breast Cancer Research. 13(1), R19. [Abstract]


  • Hochgräfe, F., Zhang, L., O'Toole, S., Browne, B., Pinese, M., Porta Cubas, A., Lehrbach, G., Croucher, D., Rickwood, D., Boulghourjian, A., Shearer, R., Nair, R., Swarbrick, A., Faratian, D., Mullen, P., Harrison, D., Biankin, A., Sutherland, R., Raftery, M., Daly, R. (2010), Tyrosine Phosphorylation Profiling Reveals the Signaling Network Characteristics of Basal Breast Cancer Cells. Cancer research. 70(22), 9391-401. [Abstract]
  • Fleuren, E., O'Toole, S., Millar, E., McNeil, C., Lopez-Knowles, E., Boulghourjian, A., Croucher, D., Schramek, D., Brummer, T., Penninger, J., Sutherland, R., Daly, R. (2010), Overexpression of the oncogenic signal transducer Gab2 occurs early in breast cancer development. International journal of cancer. Journal international du cancer. 127(6), 1486-92. [Abstract]
  • Murphy, N., Biankin, A., Millar, E., McNeil, C., O'Toole, S., Segara, D., Crea, P., Olayioye, M., Lee, C., Fox, S., Morey, A., Christie, M., Musgrove, E., Daly, R., Lindeman, G., Henshall, S., Visvader, J., Sutherland, R. (2010), Loss of STARD10 expression identifies a group of poor prognosis breast cancers independent of HER2/Neu and triple negative status. International journal of cancer. Journal international du cancer. 126(6), 1445-53. [Abstract]
  • Palmer, C., Corpuz, T., Guirguis, M., O'Toole, S., Yan, K., Bu, Y., Jorgenson, J., Talbot, M., Lloyd, A., Zekry, A. (2010), The effect of obesity on intrahepatic cytokine and chemokine expression in chronic hepatitis C infection. Gut. 59(0), 397-404. [Abstract]
  • López-Knowles, E., O'Toole, S., McNeil, C., Millar, E., Qiu, M., Crea, P., Daly, R., Musgrove, E., Sutherland, R. (2010), PI3K pathway activation in breast cancer is associated with the basal-like phenotype and cancer-specific mortality. International journal of cancer. Journal international du cancer. 126(5), 1121-31. [Abstract]
  • Zardawi, S., Zardawi, I., McNeil, C., Millar, E., McLeod, D., Morey, A., Crea, P., Murphy, N., Pinese, M., Lopez-Knowles, E., Oakes, S., Ormandy, C., Qiu, M., Hamilton, A., Spillane, A., Soon Lee, C., Sutherland, R., Musgrove, E., O'Toole, S. (2010), High Notch1 protein expression is an early event in breast cancer development and is associated with the HER-2 molecular subtype. Histopathology. 56(3), 286-296. [Abstract]
  • Nair, R., Junankar, S., O'Toole, S., Shah, J., Borowsky, A., Bishop, J., Swarbrick, A. (2010), Redefining the expression and function of the inhibitor of differentiation 1 in mammary gland development. PLoS One. 5(8), e11947. [Abstract]
  • López-Knowles, E., Zardawi, S., McNeil, C., Millar, E., Crea, P., Musgrove, E., Sutherland, R., O'Toole, S. (2010), Cytoplasmic localization of beta-catenin is a marker of poor outcome in breast cancer patients. Cancer Epidemiology, Biomarkers & Prevention. 19(1), 301-309. [Abstract]


  • Millar, E., Graham, P., O'Toole, S., McNeil, C., Browne, L., Morey, A., Eggleton, S., Beretov, J., Theocharous, C., Capp, A., Nasser, E., Kearsley, J., Delaney, G., Papadatos, G., Fox, C., Sutherland, R. (2009), Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. Journal of Clinical Oncology. 27(28), 4701-4708. [Abstract]
  • O'Toole, S., Swarbrick, A., Sutherland, R. (2009), The Hedgehog signalling pathway as a therapeutic target in early breast cancer development. Expert Opinion On Therapeutic Targets. 13(9), 1095-1103. [Abstract]
  • Millar, E., Dean, J., McNeil, C., O'Toole, S., Henshall, S., Tran, T., Lin, J., Quong, A., Comstock, C., Witkiewicz, A., Musgrove, E., Rui, H., Lemarchand, L., Setiawan, V., Haiman, C., Knudsen, K., Sutherland, R., Knudsen, E. (2009), Cyclin D1b protein expression in breast cancer is independent of cyclin D1a and associated with poor disease outcome. Oncogene. 28(15), 1812-1820. [Abstract]
  • Zardawi, S., O'Toole, S., Sutherland, R., Musgrove, E. (2009), Dysregulation of Hedgehog, Wnt and Notch signalling pathways in breast cancer. Histology and histopathology. 24(3), 385-398. [Abstract]
  • Tan, E., Yan, M., Campo, L., Han, C., Takano, E., Turley, H., Candiloro, I., Pezzella, F., Gatter, K., Millar, E., O'Toole, S., McNeil, C., Crea, P., Segara, D., Sutherland, R., Harris, A., Fox, S. (2009), The key hypoxia regulated gene CAIX is upregulated in basal-like breast tumours and is associated with resistance to chemotherapy. British journal of cancer. 100(2), 405-11. [Abstract]
  • Millar, E., Anderson, L., McNeil, C., O'Toole, S., Pinese, M., Crea, P., Morey, A., Biankin, A., Henshall, S., Musgrove, E., Sutherland, R., Butt, A. (2009), BAG-1 predicts patient outcome and tamoxifen responsiveness in ER-positive invasive ductal carcinoma of the breast. British Journal of Cancer. 100(1), 123-133. [Abstract]
  • Kitzing, B., O'Toole, S., Waugh, A., Clayton, J., McGill, N., Allman, K. (2009), Hepatobiliary scintigraphy in vasculitis of the gallbladder as a manifestation of polyarteritis nodosa: a case report. Cases Journal. 2, 9300. [Abstract]