Tumor dormancy at bedside: A late awakening

Breast. 2019 Jun:45:61-63. doi: 10.1016/j.breast.2019.03.001. Epub 2019 Mar 2.

Abstract

Breast cancer recurrence may occur at variable times following primary tumor removal. The corresponding event dynamics displays a structured multipeak pattern, which can be explained by the occurrence of microscopic phases of metastasis quiescence (tumor dormancy) followed by wake up, growth and timed clinical appearance. This model provides a meaningful justification of the early recurrence pattern and even explains the effectiveness of adjuvant systemic therapies. Yet, late recurrences, which were less investigated, are fairly little known and a few researchers supported their steady state appearance. We report here the analysis of the late clinical course from patients who were disease-free at 5 years of follow-up, which again displays a structured pattern, supporting the view that tumor dormancy can explain the late recurrence risk as well. Tailored treatments are needed to address late clinical recurrences.

Keywords: Breast cancer; Late recurrences; Recurrence dynamics; Tumor dormancy; Tumor homeostasis.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Axilla
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / therapy
  • Chemotherapy, Adjuvant / mortality
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Lymph Nodes / pathology
  • Mastectomy / mortality
  • Middle Aged
  • Neoplasm Recurrence, Local / etiology*
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / therapy
  • Postoperative Period
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk Factors
  • Time Factors*
  • Tumor Burden