Surgery Triggers Outgrowth of Latent Distant Disease in Breast Cancer: An Inconvenient Truth?
Abstract
:1. Introduction
2. Models, Cancer Models and the Natural History of Breast Cancer
2.1. The Natural History of Breast Cancer
2.2. The Nature of Models and Models of Nature
2.3. An Organic Example is the Rose Bush
2.4. The Natural History of an Automobile and a Rose
2.5. The History of Ideas Concerning the Nature of Breast Cancer
2.6. Breast Cancer in the 19thC and Early 20thC
2.7. The Influence of Surgery on the Natural History of Breast Cancer.
2.8. The Biological Revolution of the Late 20thC
2.9. Phenomena that Challenge the Existing Models
2.10. Adjuvant Systemic Therapy Has Only a Modest Effect on Survival
2.11. When Does a Primary Tumor Seed Its Secondaries?
2.12. A New Model to Explain the Natural History of Breast Cancer
3. Effects of Primary Surgical Removal on the Tumor System
3.1. Earlier Studies: Phenomena Recognized and General Traits Outlined
- A primary tumor of sufficient size inhibits the development and growth of its distant spontaneous metastases.
- Metastases become established and grow prior to the primary tumor becoming large.
- Removal of the primary results in the establishment and rapid growth of large numbers of latent metastases, the majority of which would have been dormant or would have succumbed if the primary tumor had not been removed.
- The growth-stimulating effects on metastases postoperatively are due to removal of primary.
3.2. More Recent Times: Looking for the Mechanisms
3.3. Findings from Clinical Studies
3.4. A New Way to Address the Question
4. A New Point of View for a Few Uncertain Questions
4.1. Mammography Paradox for Women Age 40–49
4.2. Highest Sensitivity to Adjuvant Chemotherapy for Premenopausal Node-positive Patients
4.3. Heterogeneity of Breast Cancer and Aggressiveness of Breast Cancer in Young Women
4.4. Excess Breast Cancer Mortality for African American Women
5. Concluding Statements
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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. https://doi.org/10.3390/cancers2020305
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. https://doi.org/10.3390/cancers2020305
Chicago/Turabian StyleRetsky, Michael, Romano Demicheli, William Hrushesky, Michael Baum, and Isaac Gukas. 2010. "Surgery Triggers Outgrowth of Latent Distant Disease in Breast Cancer: An Inconvenient Truth?" Cancers 2, no. 2: 305-337. https://doi.org/10.3390/cancers2020305