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首页> 外文期刊>APMIS: Acta Pathologica, Microbiologica et Immunologica Scandinavica >Dormancy and surgery-driven escape from dormancy help explain some clinical features of breast cancer.
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Dormancy and surgery-driven escape from dormancy help explain some clinical features of breast cancer.

机译：休眠和手术导致的逃避休眠有助于解释乳腺癌的某些临床特征。

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摘要

To explain bimodal relapse patterns observed in breast cancer data, we have proposed that metastatic breast cancer growth commonly includes periods of temporary dormancy at both the single cell phase and the avascular micrometastasis phase. The half-lives of these states are 1 and 2 years respectively. We also suggested that surgery to remove the primary tumor often terminates dormancy resulting in accelerated relapses. These iatrogenic events are 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 early detection, through treatment and follow-up, and consider how dormancy and surgery-driven escape from dormancy would be observed. We examine mammography data, effectiveness of adjuvant chemotherapy, heterogeneity and aggressiveness, timing of surgery within the menstrual cycle and racial differences in outcome. Dormancy can be identified in these diverse data but most conspicuous is the sudden escape from dormancy following primary surgery. These quantitative findings provide linkage between experimental studies of tumor dormancy and clinical efforts to improve patient outcome.
机译：为了解释在乳腺癌数据中观察到的双峰复发模式，我们提出转移性乳腺癌的生长通常包括在单细胞期和无血管微转移期的暂时休眠期。这些州的半衰期分别为1年和2年。我们还建议，切除原发肿瘤的手术通常会终止休眠，导致复发加速。这些医源性事件非常普遍，因为所有转移性复发中有超过一半以这种方式进展。假设这是真的，则临床数据中应有充足而明确的证据。我们在这里回顾了从早期发现到治疗和随访的乳腺癌范例，并考虑了如何观察休眠和手术驱动的休眠逃逸现象。我们检查了乳腺X线摄影数据，辅助化疗的有效性，异质性和侵略性，月经周期内的手术时机以及种族差异。可以从这些不同的数据中识别出休眠状态，但是最明显的是在一次手术后突然从休眠状态逃脱。这些定量的发现为肿瘤休眠的实验研究与改善患者预后的临床努力之间提供了联系。

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