The maintenance of genomic stability is one of the most important defenses
against neoplastic transformation. This objective must be accomplished desp
ite a constant barrage of spontaneous DNA double strand breaks. These dange
rous lesions are corrected by two primary pathways of double strand break r
epair; non homologous end joining and homologous recombination. Recent stud
ies employing mouse models have shown that absence of either pathway leads
to genomic instability, including potentially oncogenic translocations. Bec
ause translocations involve the union of different chromosomes, cellular ma
chinery must exist that creates these structures in the context of unrepair
ed double strand breaks. Evidence is mounting that the pathways of double s
trand break repair that are so important for survival may themselves be the
culprits that generate potentially fatal translocations. Evidence and mode
ls for the dual roles of double strand break repair in both preventing, and
generating, oncogenic karyotypic changes are discussed.