Annals of Surgical Oncology, 11(9):818–828 DOI: 10.1245/ASO.2004.02.019 Educational Review Models of Breast Cancer Growth and Investigations of Adjuvant (2004)
BibTeX
@MISC{Oophorectomy04annalsof,
author = {Surgical Oophorectomy and Richard R. Love and John E. Niederhuber},
title = {Annals of Surgical Oncology, 11(9):818–828 DOI: 10.1245/ASO.2004.02.019 Educational Review Models of Breast Cancer Growth and Investigations of Adjuvant},
year = {2004}
}
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Abstract
Clinical observations of the natural history of breast cancer and its response to a variety of therapeutic interventions have contributed to changing concepts about the growth and metastatic spread of this disease. Increased attention has been given to tumor cell dormancy and the occurrence of greatly delayed metastatic disease development, which has been important to rethinking therapy. Although gene profiling of breast tumors recently has highlighted the importance of individual tumor characteristics in patients ’ prognosis, considerable data also support the concept of breast cancer as a problem of macro- and microenvironmental regulatory imbalance and dynamic chaos. Observations of unexpectedly large survival benefits from adjuvant surgical oophorectomy done in the luteal phase of the menstrual cycle in premenopausal women are consistent with an interpretation that extratumoral interactions in the host environment are important in prognosis. These observations also suggest that a treatment paradigm shift from an exclusive focus on cell kill and specific tumor cell molecular targets to one focused also on broad host regulatory control may be useful. Clinical trials and laboratory mechanistic investigations based on these data and observations can determine the potential impact of therapeutic interventions targeting host system macro and micro tumor cell environments.
Keyphrases
educational review model surgical oncology breast cancer growth breast cancer therapeutic intervention patient prognosis large survival benefit laboratory mechanistic investigation potential impact exclusive focus gene profiling micro tumor cell environment treatment paradigm shift host system macro host environment considerable data clinical observation microenvironmental regulatory imbalance specific tumor cell molecular target luteal phase clinical trial cell kill metastatic disease development menstrual cycle premenopausal woman cell dormancy metastatic spread individual tumor characteristic broad host regulatory control breast tumor adjuvant surgical oophorectomy dynamic chaos natural history extratumoral interaction
