The articulate review by Demichelli et al. in this issue of the journal goes beyond identifying deficiencies in our current understanding of breast cancer, to state a provocative hypothesis. The authors contend that continuous growth of cancerous masses cannot explain the observed time durations between primary resections and local or distant recurrences or deaths. They then posit that the growth curves must be interrupted by variable periods of dormancy. Furthermore, they argue that surgical removal of a primary tumor might shorten durations of dormancy and thereby promote the appearance of metastases. Such intended iconoclasm demands attention, even if the contained details evoke vigorous disputation.
展开▼
