Postmenopausal breast cancer: European challenge and innovative concepts

EPMA J. 2017 May 30;8(2):159-169. doi: 10.1007/s13167-017-0094-6. eCollection 2017 Jun.

Abstract

Breast cancer (BC) epidemic is recognised now worldwide as the reality of the early twenty-first century. Increasing trends in the postmenopausal BC prevalence, even for the European countries earlier demonstrating relatively stable incidence rates of the disease, are highly alarming for the healthcare givers. This new actuality requires a substantial revision of the paradigm currently applied to the BC management and creation of highly innovative concepts. Current multi-centred study highlights new complex mechanisms of the development and progression of the postmenopausal BC. Innovative concepts are presented which argue for more effective predictive and preventive approaches well justified in view of the clusters of the symptoms analysed here and demonstrated as highly prevalent in the postmenopausal breast cancer versus BC-free individuals. Another conceptual novelty presented here is a new interpretation of the "Seed and Soil" theory of metastasis in BC. According to the new concept, the "pre-metastatic niches" ("Soil") are created by a systemic hypoxia a long time before the breast malignancy is clinically manifested.

Keywords: Cardiovascular component; Diabetes; Drug sensitivity; Flammer syndrome; Metastatic disease; Pain; Patient stratification; Postmenopausal breast cancer; Predictive preventive and personalised medicine; Risk factors; Systemic hypoxia; “Seed and soil” theory.