The biology of metastatic breast cancer

Article Abstract:

Metastasis, the ability of some tumor cells to spread to other organs of the body, is the hallmark of cancer and is what distinguishes cancer from other nonmalignant tumors and growths. In the case of breast cancer, the presence of metastatic breast cancer cells in the lymph nodes is the single most important prognostic factor for the disease. The metastatic spread of breast cancer to other organs is the most common cause of death from breast cancer. This spread, however, is far from random, and the lungs, brain, liver, and bones are the most common sites of metastatic growth. To this day, cancer biologists consider the ''seed and soil'' metaphor first suggested by Stephen Paget in 1889. The evidence suggests that properties of the cancer cells and properties of the organ must both be right for metastatic growth to take place. That this spread of cancer is not just a matter of cancer cells being sprinkled through the body may be demonstrated by grafting a preferred tissue, such as lung, into a site such as a limb of an experimental rat. Although the grafted tissue does not catch a disproportionate number of injected cancer cells, the cells that do settle are able to survive and grow. The precise characteristics that determine the viability of a certain site as a new location for tumor growth remain obscure. Also obscure are the characteristics of cancer cells that cause them to metastasize. Analysis of messenger RNA (mRNA) within cancer cells has demonstrated that some mRNAs are present in much higher quantities among the cancer cells in the original site than in those that have left for new territory. While it can be shown that cancer cells expressing these molecules do not metastasize in experimental conditions, what these molecules are and what they do remains a mystery. A great deal of current research is investigating the function of oncogenes (cancer-causing genes) and their normal cousins, the proto-oncogenes. It is hoped that as the mechanisms of the genes and their products become clearer, some insight into the mechanisms of metastasis will be gained, as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

Genetic aspects, Metastasis

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Adenoid cystic carcinoma of the breast metastatic to the kidney: a clinically symptomatic lesion requiring surgical management

Article Abstract:

Adenoid cystic carcinoma (ACC) is a form of cancer defined by its histological appearance under the microscope. Adenoid cystic carcinoma of the breast is rare, representing only about 1 in 1,000 cases of breast cancer. The prognosis for ACC is generally excellent; the cancer shows little propensity for metastatic spread to other parts of the body. When cancers that rarely metastasize do spread, there is little experience on which to base a reasonable therapeutic decision. The authors present the case of apparently successful treatment of an adenoid cystic carcinoma of the breast that metastasized to the kidney; this is the first reported instance of a kidney metastasis resulting from this tumor. The patient underwent modified radical mastectomy for ACC of the breast at the age of 57. Six years later, routine follow-up identified the presence of a metastatic lesion in the lung; this tumor was also removed surgically. Twelve years after the initial mastectomy, blood began appearing in the patients urine; she also passed blood clots. Imaging methods revealed a mass on the pole of the left kidney. The patient was then examined for indications of metastatic disease elsewhere in her body. When none were found, the decision was made to remove the cancerous left kidney; the operation was uneventful, and pathologic examination of the kidney confirmed that the tumor mass was metastatic ACC. The patient remains free of disease more than 20 months after the nephrectomy. This case illustrates that the rare metastatic adenoid cystic carcinoma of the breast may yield readily to aggressive surgical treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Surgery, Kidney cancer, Adenocystic carcinoma

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Breast cancer metastatic to the eye is a common entity

Article Abstract:

It has long been believed that the most common cancer of the eye was primary uveal malignant melanoma, which arises within the eye itself. It has now become clear that the most common cancers of the eye do not begin in the eye, but are metastatic tumors, which arise elsewhere in the body and then spread to other locations. The most common type of metastatic cancer of the eye is from breast cancer. The spread of breast cancer to the eye appears to be quite frequent, affecting up to 30 percent of women with advanced breast cancer. It is estimated that each year about 11,000 women will be afflicted with metastatic breast cancer of the eye. Six case reports are presented that illustrate the typical characteristics of patients with metastatic breast cancer of the eye. Common symptoms suggesting the presence of eye tumors are metamorphopsia (the visual distortion of objects), and scotomata (patches of blind spots within the visual field). If these symptoms are observed in a woman with a history of breast cancer, follow-up to determine if metastatic cancer is present in the eye should not be delayed. With early treatment, it is often possible to alleviate the visual symptoms and control the tumor mass within the eye. Generally, the diagnosis of metastatic breast cancer in the eye is not difficult. A combination of ophthalmological examination, CT scanning, or magnetic resonance imaging is sufficient to confirm the diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Eye cancer

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