Wherein the Authors Attempt to Minimize the Confusion Generated by Their Study “Breast Cancer Mortality after a Diagnosis of Ductal Carcinoma In Situ” by Several Commentators Who Disagree with Them and a Few Who Don’t: A Qualitative Study

Narod, Steven A.; Ahmed, Humayun; Sopik, Victoria

doi:10.3747/co.24.3626

Cited by 3 publications

(1 citation statement)

References 53 publications

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“…However, preventing the invasive in-breast recurrence after DCIS did not result in fewer deaths—therefore, the recurrence is not a primary invasive cancer—therefore, the DCIS has inherent malignant potential. Our position here has not been widely accepted—most commentators continue to describe DCIS as a precursor lesion with little or no inherent malignant potential [ 43 ].…”

Section: Part 2: the Seer Study: Mortality After Dcismentioning

confidence: 99%

Is invasion a necessary step for metastases in breast cancer?

Narod

Sopik

2018

Breast Cancer Res Treat

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PurposeTo review the empirical evidence to support the conventional (sequential) model of breast cancer progression, which is based on the paradigm that cancer passes through several stages, including an in situ stage prior to an invasive stage, and thereafter (in some cases) disseminates to the lymph nodes and distant organs.MethodsWe review the cancer literature of the last 50 years which relates to the prevention of invasive breast cancer (through radiotherapy or surgery) and reductions in the mortality for breast cancer.ResultsFor both invasive cancers and DCIS, the literature indicates that prevention of in-breast invasive recurrences does not prevent death from breast cancer. Moreover, the presence of residual cancer cells in the breast after breast-conserving surgery does not compromise the cure rate.ConclusionWe propose an alternate (parallel) model of breast cancer wherein there is a small pool of cancer stem cells which have metastatic potential from their inception and which disseminate synchronously through several routes—to the breast stroma, to the lymph nodes and to distant organs. Cancer cells which disseminate to the breast give rise to cells which make up the bulk of the tumour mass but these are not the source of the distant metastases.

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Section: Part 2: the Seer Study: Mortality After Dcismentioning

confidence: 99%