生物等效性和生物利用度杂志

抽象的

Breast Cancer is Usually Described as Uncontrolled Cellular Growth However Recent Research Suggests That is not Accurate - At Least before Primary Surgery

Michael Retsky

In 1993 my colleagues and I were confronted with data that showed a bimodal pattern for relapse after surgery to remove primary breast cancer. This was quite unexpected since tumor growth was considered to be steady and continuous. Starting with a simple tumor growth model we proceeded to develop a computer simulation that might explain these data. We determined that over half of all relapses in breast cancer are accelerated by something related to primary surgery. These findings have also been used to explain a number of clinical features of breast cancer that were previously thought to be unrelated. This information has been published several times and for full discussion the reader is referred to our reviews. What has not been discussed previously is why we felt confident that these data were of sufficient high quality that we could make such dramatic conclusions. That is, there were literally hundreds of previous reports of breast cancer relapse that did not cite a bimodal relapse. Why is one found in the Milan database and why did we feel confident enough to make strong and counterintuitive conclusions? As final remarks, at risk of pontification, the cancer research community is advised that instead of cancer being categorized as uncontrolled cellular growth, it is mostly quiescent at least before primary surgery. The cancer research community’s emphasis on discovering cancer growth pathways and how to block these pathways may be misdirected. Thus it is recommended that cancer research be redirected towards understanding why and how cancer is restrained before surgery and how that state may be retained for indefinite periods of time to avoid relapse.