In terms of dollars available for research and the sheer number of drugs and other interventions available, there has been great success. The question is impact: what has 40 years and billions of dollars produced? Despite years of campaigns to raise awareness, ever expanding screening programs, and increased fundraising and research, breast cancer incidence has increased and mortality has not changed dramatically. It is time for a radically new approach. By leveraging all available resources in a collaborative and rapid research process, it will be possible to cultivate the development of innovative ideas that will ultimately end breast cancer.