The London Breast Institute, Princess Grace Hospital, London, U.K.
Anticancer Res. 2024 Aug;44(8):3317-3319. doi: 10.21873/anticanres.17150.
Breast cancer, a multifaceted disease, presents a dynamic ecosystem where the primary tumor interacts intricately with its microenvironment, circulatory system, and distant organs. Circulating tumor cells (CTCs) disseminate from the primary tumor to organs, such as the brain, lungs, liver, and bones, encountering various fates: cell death, cellular dormancy, or senescence. Dormant cells, characterized by reversible growth arrest at the G/G phase of the cell cycle, pose a significant challenge as they evade conventional treatments and can later reawaken, leading to cancer relapse. The phenomenon of tumor dormancy is influenced by the tumor microenvironment, immune modulation, and cellular adaptations. Emerging evidence suggests that breast-conserving surgery coupled with radiation therapy offers superior survival benefits compared to mastectomy, potentially due to the 'breast homing phenomenon.' This hypothesis posits that residual breast tissue provides a niche for reactivated dormant cells, reducing distant metastasis. Immunotherapy and lifestyle modifications, including diet and exercise, show promise in managing dormant cells. Understanding the mechanisms of dormancy and developing targeted therapies are crucial for achieving long-term remission and potentially curing breast cancer.
乳腺癌是一种多方面的疾病，呈现出一个动态的生态系统，其中原发肿瘤与微环境、循环系统和远处器官相互交织。循环肿瘤细胞（CTC）从原发肿瘤扩散到脑、肺、肝和骨等器官，会遇到各种命运：细胞死亡、细胞休眠或衰老。休眠细胞的特征是细胞周期的 G1/G0 期可逆性生长停滞，它们逃避常规治疗，以后可能重新激活，导致癌症复发，这给它们带来了很大的挑战。肿瘤休眠现象受肿瘤微环境、免疫调节和细胞适应的影响。新出现的证据表明，保乳手术联合放疗比乳房切除术提供更好的生存益处，这可能归因于“乳腺归巢现象”。这一假说认为，残留的乳腺组织为重新激活的休眠细胞提供了一个小生境，从而减少远处转移。免疫疗法和生活方式的改变，包括饮食和锻炼，在控制休眠细胞方面显示出希望。了解休眠机制并开发靶向治疗方法对于实现长期缓解和可能治愈乳腺癌至关重要。
