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Clinical & Experimental Metastasis
Published in: Clinical & Experimental Metastasis 5-6/2018

01-08-2018 | Research Paper

Breast cancer metastasis through the lympho-vascular system

Authors: S. David Nathanson, David Krag, Henry M. Kuerer, Lisa A. Newman, Markus Brown, Dontscho Kerjaschki, Ethel R. Pereira, Timothy P. Padera

Published in: Clinical & Experimental Metastasis | Issue 5-6/2018

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Abstract

Breast cancer metastasizes through the lymphovascular system to the regional lymph nodes in the axilla and to both visceral and non-visceral sites. Renewed interest in the route by which tumor cells gain access to blood and lymphatic capillaries are the subject of research at mechanical, anatomic, pathologic, genetic, epidemiologic and molecular levels. Two papers presented at the 7th International Symposium on Cancer Metastasis in San Francisco showed tumor cells entering the systemic circulation through the sentinel lymph node. This information challenges the current paradigm where clinicians believe that access is gained through intra- and peri-tumoral blood vessels and that metastasis to axillary lymph nodes is an interesting epi-phenomenon. The sentinel lymph node era has changed the modern surgical approach to the axilla and the basis of this change is summarized in this paper. A new approach to the management of axillary metastases after systemic therapy relies on determining whether there is a complete pathologic response; if no tumor is found in the previously biopsied node, a complete axillary lymph node dissection may be avoided. African American women seem to inherit a trait from West African ancestors and tend to develop more lethal types of breast cancer. These tumors may have a molecular machinery that enhances their ability to metastasize to visceral sites and future research may unearth the mechanisms for this phenomenon.
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Metadata
Title
Breast cancer metastasis through the lympho-vascular system
Authors
S. David Nathanson
David Krag
Henry M. Kuerer
Lisa A. Newman
Markus Brown
Dontscho Kerjaschki
Ethel R. Pereira
Timothy P. Padera
Publication date
01-08-2018
Publisher
Springer Netherlands
Published in
Clinical & Experimental Metastasis / Issue 5-6/2018
Print ISSN: 0262-0898
Electronic ISSN: 1573-7276
DOI
https://doi.org/10.1007/s10585-018-9902-1

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