Smokovski Ivica, Risteski Milan, Polivka Jiri, Zubor Pavol, Konieczka Katarzyna, Costigliola Vincenzo, Golubnitschaja Olga
Faculty of Medical Sciences, University Goce Delcev Stip, Stip, Macedonia.
Diabetes and Metabolic Disorders, University Clinic of Endocrinology, Skopje, Macedonia.
EPMA J. 2017 May 30;8(2):159-169. doi: 10.1007/s13167-017-0094-6. eCollection 2017 Jun.
Breast cancer (BC) epidemic is recognised now worldwide as the reality of the early twenty-first century. Increasing trends in the postmenopausal BC prevalence, even for the European countries earlier demonstrating relatively stable incidence rates of the disease, are highly alarming for the healthcare givers. This new actuality requires a substantial revision of the paradigm currently applied to the BC management and creation of highly innovative concepts. Current multi-centred study highlights new complex mechanisms of the development and progression of the postmenopausal BC. Innovative concepts are presented which argue for more effective predictive and preventive approaches well justified in view of the clusters of the symptoms analysed here and demonstrated as highly prevalent in the postmenopausal breast cancer versus BC-free individuals. Another conceptual novelty presented here is a new interpretation of the "Seed and Soil" theory of metastasis in BC. According to the new concept, the "pre-metastatic niches" ("Soil") are created by a systemic hypoxia a long time before the breast malignancy is clinically manifested.
乳腺癌(BC)流行如今在全球范围内被视为21世纪初的现实情况。绝经后乳腺癌患病率呈上升趋势,即使是那些早期显示该疾病发病率相对稳定的欧洲国家也是如此,这让医疗保健人员深感担忧。这种新情况需要对目前应用于乳腺癌管理的范式进行重大修订,并创建高度创新的概念。当前的多中心研究突出了绝经后乳腺癌发生和发展的新复杂机制。鉴于此处分析的症状群,并证明在绝经后乳腺癌患者与无乳腺癌个体中高度普遍,本文提出了创新概念,主张采用更有效的预测和预防方法。本文提出的另一个概念新颖之处是对乳腺癌转移的“种子与土壤”理论的新解释。根据这一新概念,“前转移微环境”(“土壤”)在乳腺恶性肿瘤临床显现之前很长时间就由全身性缺氧形成。