TY  - CHAP
M1  - Book, Section
TI  - Chapter 3. Metastasis
A1  - Allan, Alison L.
A2  - Kuerer, Henry M.
Y1  - 2010
N1  - 
T2  - Kuerer's Breast Surgical Oncology
AB  - Breast  cancer  remains  a  leading  cause  of  morbidity  and  mortality  in  women,1  mainly  due  to  the  propensity  of  primary  breast  tumors  to  metastasize  to  regional  and  distant  sites  and  the  failure  of  effective  clinical  management  of  metastatic  disease.2,3  Primary  therapy  for  breast  cancer  usually  involves  surgical  resection  of  the  tumor  (lumpectomy  or  mastectomy),  alone  or  in  combination  with  local  radiotherapy.  As  discussed  in  later  chapters,  factors  such  as  tumor  size,  grade,  lymph  node  involvement,  and  hormonal  status  provide  valuable  information  for  prognosis.  If  the  patient  is  felt  to  have  a  reasonably  high  probability  of  harboring  micrometastases,  then  adjuvant  systemic  drug  therapy  (cytotoxic  or  hormonal)  is  usually  recommended.4  This  adjuvant  approach  has  several  problems,  including  both  unnecessary  treatment  of  patients  who  may  have  been  truly  cured  by  their  primary  treatment  alone,  as  well  as  the  fact  that  many  patients  may  relapse  despite  treatment  (adjuvant  therapy  typically  only  reduces  the  risk  of  recurrence  by  25-30%).5  A  better  understanding  of  the  biology  of  metastasis  can  improve  clinical  management  and  provide  the  potential  for  developing  novel  prognostic  and/or  therapeutic  strategies  to  combat  metastatic  breast  cancer.  This  chapter  will  review  what  is  currently  known  about  the  metastatic  process,  including  the  timing  and  steps  involved  the  metastatic  cascade,  the  organ-specific  nature  of  breast  cancer  metastasis,  the  contribution  of  specific  molecular  factors  to  metastatic  disease,  and  the  issue  of  tumor  dormancy.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=6405382
ER  -