EDITORIAL   

Panminerva Medica 2000 September;42(3):171-3

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Long-term relapses of breast cancer: questions, interpretations and hypotheses

Basso Ricci S.

From the Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy

The ­author has dem­on­strat­ed in pre­vi­ous pub­li­ca­tions ­that the con­sis­tent char­ac­ter­is­tic of ­long-­term relaps­es of car­ci­no­ma ­after ­more ­than 8 ­years ­from sur­gery is hor­mone depen­dence, ­since ­long-­term relaps­es ­occur ­almost exclu­sive­ly in hor­mone-depen­dent ­tumors ­such as car­ci­no­ma of the ­breast, pros­tate, endo­me­tri­um and thy­roid. Such pub­li­ca­tions pre­sent­ed a ­series of 237 ­long ­term relaps­es of ­breast can­cer ­that ­occurred at no ­less ­than 8 ­years ­from the mas­tec­to­my, ­which ­proved ­that all the ­patients ­were estro­gen-recep­tor pos­i­tive. Estrogen-neg­a­tive cas­es who did not ­relapse ­after 8 ­years ­from sur­gery ­should be con­sid­ered ­cured, as is ­found for cas­es of non-hor­mone-depen­dent ­tumors. Therefore, the ­study dem­on­strates ­that ­breast can­cer, with­out the pres­ence of hor­mone recep­tors (­which influ­ence clin­i­cal behav­ior) is sim­i­lar to neo­plasms ­that ­arise in all ­parts of the ­body. The ­author here­in ­presents a per­son­al hypoth­e­sis rel­a­tive to the pos­sibil­ity ­that the pres­ence of recep­tors indi­rect­ly con­di­tions the for­ma­tion of anti­mi­tot­ic fac­tors up to deter­min­ing in ­some cas­es the phe­nom­e­non of ­long-­term relaps­es. Such fac­tors are pre­sum­ably phys­io­log­i­cal, and the pos­sibil­ity ­that ­such a hypoth­e­sis can ­also ­serve to ­explain the ­results ­obtained ­with hor­mone ther­a­py of ­breast can­cer is exam­ined.