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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2018

Open Access 01-05-2018 | Review

Is invasion a necessary step for metastases in breast cancer?

Authors: Steven A. Narod, Victoria Sopik

Published in: Breast Cancer Research and Treatment | Issue 1/2018

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Abstract

Purpose

To review the empirical evidence to support the conventional (sequential) model of breast cancer progression, which is based on the paradigm that cancer passes through several stages, including an in situ stage prior to an invasive stage, and thereafter (in some cases) disseminates to the lymph nodes and distant organs.

Methods

We review the cancer literature of the last 50 years which relates to the prevention of invasive breast cancer (through radiotherapy or surgery) and reductions in the mortality for breast cancer.

Results

For both invasive cancers and DCIS, the literature indicates that prevention of in-breast invasive recurrences does not prevent death from breast cancer. Moreover, the presence of residual cancer cells in the breast after breast-conserving surgery does not compromise the cure rate.

Conclusion

We propose an alternate (parallel) model of breast cancer wherein there is a small pool of cancer stem cells which have metastatic potential from their inception and which disseminate synchronously through several routes—to the breast stroma, to the lymph nodes and to distant organs. Cancer cells which disseminate to the breast give rise to cells which make up the bulk of the tumour mass but these are not the source of the distant metastases.
Appendix
Available only for authorised users
Footnotes
1
Consider for example the observation that men with nicotine-stained teeth have a much higher risk of dying of lung cancer than men with unstained teethed (perhaps 20-fold higher). This does not imply that brushing your teeth prevents lung cancer.
 
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Metadata
Title
Is invasion a necessary step for metastases in breast cancer?
Authors
Steven A. Narod
Victoria Sopik
Publication date
01-05-2018
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-017-4644-3

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