%0 Journal Article
%T Pathways to Breast Cancer Recurrence
%A Aamir Ahmad
%J ISRN Oncology
%D 2013
%R 10.1155/2013/290568
%X Breast cancer remains a deadly disease, even with all the recent technological advancements. Early intervention has made an impact, but an overwhelmingly large number of breast cancer patients still live under the fear of ˇ°recurrentˇ± disease. Breast cancer recurrence is clinically a huge problem and one that is largely not well understood. Over the years, a number of factors have been studied with an overarching aim of being able to prognose recurrent disease. This paper attempts to provide an overview of our current knowledge of breast cancer recurrence and its associated challenges. Through a survey of the literature on cancer stem cells (CSCs), epithelial-mesenchymal transition (EMT), various signaling pathways such as Notch/Wnt/hedgehog, and microRNAs (miRNAs), we also examine the hypotheses that are currently under investigation for the prevention of breast cancer recurrence. 1. Breast Cancer: The Problem Breast cancer is a major health problem that affects the lives of millions. For the year 2012, it was estimated that 226,870 women in the United States will be diagnosed with breast cancer and that 39,510 women will succumb to it [1, 2]. With these numbers, breast cancer is the leading cancer diagnosed in the US women and is second only to lung cancer in terms of total fatalities [1]. It is generally recognized that much scientific advancements have been made in the area of breast cancer research, and it is because of these efforts that the chances of disease-free survival of breast cancer survivors have increased tremendously over the last few decades. However, this applies only if the breast cancer is diagnosed at an early stage and is limited to the primary organ. Once breast cancer metastasizes to other organs, the therapeutic options are very limited and the success rate of managing such patients in clinics is dismal. The challenges in managing breast cancer patients are very many. First of all, although many risk factors have been associated with the possible initiation and progression of disease, nothing concrete is established that can potentially prevent the primary disease or its progression and metastases. Additionally, there are well-studied disparities in breast cancer that include socioeconomic disparities [3] as well as the racial disparities [4]. All this information seems to suggest that no two women have equal chances of developing the disease. Even when comparing among breast cancer patients, there are not very reliable predictors of aggressiveness. The advanced stage breast cancers are broadly characterized by one or both of
%U http://www.hindawi.com/journals/isrn.oncology/2013/290568/