%0 Journal Article
%T Molecular biology of breast metastasis: Clinical implications of experimental studies on metastatic inefficiency
%A Ann F Chambers
%A George N Naumov
%A Sharon A Vantyghem
%A Alan B Tuck
%J Breast Cancer Research
%D 2000
%I BioMed Central
%R 10.1186/bcr86
%X Breast cancer is the leading cause of death from cancer in women, with an estimated 300 000 deaths worldwide attributed to breast cancer in the year 1990 [1,2]. The vast majority of these deaths are due to metastasis. Women whose breast cancer is detected and treated prior to metastatic spread of cancer cells from the primary site have a higher probability of being cured of their disease, and early detection is thus of major importance. When breast cancer is detected after it is known, or suspected, to have metastasized, treatment decisions are more complex and prognosis is less favourable.Metastatic spread has traditionally been assessed by histological examination of lymph nodes for the presence of metastatic lesions. However, recent technical improvements in the ability to detect cancer cells at distant sites, in blood, bone, sentinel lymph nodes and other tissues, and either as isolated cancer cells or as small foci of cells, have made treatment decisions even more complex. There are conflicting reports as to the clinical significance of such isolated cancer cells and small foci [3*]. Should they be considered as metastases, with the potential to grow to clinically relevant size, or are they in some cases unrelated to clinical outcome? Should the presence of any cancer cells at sites distant from a primary tumour be considered as evidence of metastasis, and the patient thus treated aggressively? This ability to detect smaller micrometastases, and smaller numbers of isolated tumour cells, has indeed called into question the definition of 'metastasis' [4**]. The ability and likelihood of such cells to grow to form clinically relevant metastases must be clarified before the ability to detect them can be used clinically in an appropriate manner.One solution to this dilemma is to conduct clinical trials to determine the significance of cancer cells detected at sites distant from the primary tumour and their ability to predict the course of disease. Such studies clear
%K in vivo videomicroscopy
%K isolated tumour cells
%K metastatic inefficiency
%K micrometastases
%K tumour dormancy
%U http://breast-cancer-research.com/content/2/6/400