Time distribution of the recurrence risk for breast cancer patients undergoing mastectomy: Further support about the concept of tumor dormancy

摘要: Purpose To gather information on metastatic growth from the time-distribution of first treatment failure in breast cancer patients undergoing mastectomy alone.Methods: The risk recurrence at a given time after surgery was studied utilizing cause-specific hazard function. Recurrence categorized as any site, local-regional recurrence, distant metastases, and contralateral tumor. distribution assessed relative to tumor size, axillary lymph node involvement, menopausal status.Results: A total 1173 treated between 1964 1980 with alone no adjuvant therapy were studied. function for presented an early peak about 18 months surgery, second 60 then tapered plateau-like tail extending up 15 years. similar pattern detectable both local while curve tumors showed near flat plateau. recurrences much lower less than 2 cm diameter larger tumors; late small large primaries. Node-positive peaks four five times higher node-negative patients. Subdividing node-positive into 1–3 > 3 subsets did not substantially change general picture recurrence. functions premenopausal postmenopausal virtually superimposable.Conclusions: multipeak suggests that process resulting overt clinical metastases may have discrete features. Primary size could affect different ways status should be related level, pattern, does seem significantly distribution. Moreover, tumors, occurring constant throughout time, considered primary cancers. These findings reasonably explained by dormancy hypothesis, which assumes micrometastases biological steady states, most do imply growth. Tumor or microenvironment changes induce mean transition originate