Article Details
Causal Therapy of Breast Cancer Irrelevant of Age, Tumor Stage
and ER-Status: Stimulation of Estrogen Signaling Coupled With Breast Conserving
Surgery*
[ Vol. 11 ,
Issue. 3 ]
Author(s):
Zsuzsanna SubaPages 254-266 (13)
Abstract:
Background: Results of long-term studies justify that the rate of breast cancer recurrence and tumor-related mortality remains quite unpredictable, regardless of the use of any current therapeutic measures.
Objective: Since the application
of standard therapies, such as surgery, radiation, chemotherapy and
antiestrogen administration does not work as might be expected; our therapeutic
practice requires thorough rethinking.
Method: Published long-term therapeutic
results on breast cancer cases were analyzed in correlation with stage at
diagnosis, ER-status of tumors and patients’ age. The effectiveness of current
therapeutic measures was also compared by estimating the rate of tumor-free
survival, breast cancer recurrence and breast cancer-specific mortality.
Results: Diagnosis and treatment
of breast cancer at an early stage cannot improve the rate of tumor-free
survival. Poor differentiation of tumors, ER-negativity in particular, defines
poor prognosis even after applying aggressive therapies. In patients treated
with in situ breast cancer, the recurrence-rate of invasive tumor increased
directly with ageing irrespective of tumor size or ER-status at diagnosis.
Women who underwent lumpectomy without adjuvant radiation or chemotherapy
exhibited significantly better overall and breast cancer specific survival
rates than those receiving mastectomy, regardless of stage and ER-status of
tumors. Antiestrogen treatment exhibited unforeseeable effectiveness even on
targeted ERpositive tumors. Recent patents propose the detection of ESR1-gene
amplification or restoration of ER-alpha expression for prediction of effective
antiestrogen treatment, suggesting a crucial inhibitory role of
estrogen-signaling against tumorgrowth.
Conclusion: Estradiol-induced
upregulation of estrogen signaling coupled with sparing of the estrogen-rich
mammary fatpad are the most effective strategies against breast cancer.
Keywords:
Antiestrogen resistance, breast
cancer risk, DNA-stabilization, estradiol therapy, estrogen signaling,
lumpectomy, mastectomy, protective adipocytes, radiation therapy.
Affiliation:
National Institute of Oncology,
Surgical and Molecular Tumor Pathology Centre, Address: H-1122, Ráth György
str. 7-9, Budapest, Hungary.
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