Local therapy and survival in breast cancer
Neoplasm Recurrence, Local
THE EFFECT OF LOCAL THERAPY ON THE SURVIVAL OF PATIENTS WITH breast cancer has been debated for decades. Three viewpoints have been proposed on the basis of various hypotheses concerning the biology of breast cancer. Is breast cancer a local disease that spreads predictably over time to develop distant metastases? Is it a systemic disease from the outset, with distant metastases present well before diagnosis? Or is the truth somewhere in between, with many cancers being localized at diagnosis and, if untreated or recurrent, acquiring the ability to metastasize and kill? These differing views have vastly different implications for the treatment of patients. Recently, several lines of evidence have emerged that suggest answers to these questions. Copyright © 2007 Massachusetts Medical Society.
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