Cancer is responsible for 30% of all deaths in Canada. Over the past two decades, what were once considered to be homogenous diseases of a tissue (e.g., breast cancer) are now known to be heterogeneous even within well-established clinical subtypes. To better understand the individual nature of breast cancer in patients, the implementation of integrated ‘omics solutions are needed to understand the combined effects of genomic and epigenomic changes in driving cancer progression and deliver on the promise of precision medicine. Emerging research in breast cancer implicates epigenomics in the regulation of multiple cancer processes including DNA repair and treatment response. The epigenomics data available across cancer driver genes from different ethnic groups, particularly from women of African descent, which further highlights the diagnostic importance of epigenomic features in patient care. This is critical in the equitable delivery of healthcare to patients, since a significant proportion of patients may not be adequately treated due to molecular processes influenced by differences in ethnicity. This project will develop and validate novel panel-based targeted approaches for the evaluation of epigenetic alterations in breast cancer to address two major needs: improved predictive and prognostic assays for all breast cancer patients and a focused study comparing methylation profiles between cancers in Black and Asian minority ethnic groups and other ethnic groups.