Cancers 2010, 2(2), 305-337; doi:10.3390/cancers2020305
Review

Surgery Triggers Outgrowth of Latent Distant Disease in Breast Cancer: An Inconvenient Truth?

1,* email, 2email, 3email, 4email and 5email
Received: 9 March 2010; in revised form: 25 March 2010 / Accepted: 26 March 2010 / Published: 30 March 2010
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract: We review our work over the past 14 years that began when we were first confronted with bimodal relapse patterns in two breast cancer databases from different countries. These data were unexplainable with the accepted continuous tumor growth paradigm. To explain these data, we proposed that metastatic breast cancer growth commonly includes periods of temporary dormancy at both the single cell phase and the avascular micrometastasis phase. We also suggested that surgery to remove the primary tumor often terminates dormancy resulting in accelerated relapses. These iatrogenic events are apparently very common in that over half of all metastatic relapses progress in that manner. Assuming this is true, there should be ample and clear evidence in clinical data. We review here the breast cancer paradigm from a variety of historical, clinical, and scientific perspectives and consider how dormancy and surgery-driven escape from dormancy would be observed and what this would mean. Dormancy can be identified in these diverse data but most conspicuous is the sudden synchronized escape from dormancy following primary surgery. On the basis of our findings, we suggest a new paradigm for early stage breast cancer. We also suggest a new treatment that is meant to stabilize and preserve dormancy rather than attempt to kill all cancer cells as is the present strategy.
Keywords: breast cancer; dormancy; surgery induced growth; mammography; chemotherapy; primary antiangiogenic therapy
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MDPI and ACS Style

Retsky, M.; Demicheli, R.; Hrushesky, W.; Baum, M.; Gukas, I. Surgery Triggers Outgrowth of Latent Distant Disease in Breast Cancer: An Inconvenient Truth? Cancers 2010, 2, 305-337.

AMA Style

Retsky M, Demicheli R, Hrushesky W, Baum M, Gukas I. Surgery Triggers Outgrowth of Latent Distant Disease in Breast Cancer: An Inconvenient Truth? Cancers. 2010; 2(2):305-337.

Chicago/Turabian Style

Retsky, Michael; Demicheli, Romano; Hrushesky, William; Baum, Michael; Gukas, Isaac. 2010. "Surgery Triggers Outgrowth of Latent Distant Disease in Breast Cancer: An Inconvenient Truth?" Cancers 2, no. 2: 305-337.

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