NON-THEMATIC REVIEW

Cancer and Metastasis Reviews

, Volume 30, Issue 2, pp 161-176

True local recurrences do not metastasize

  • Dieter HölzelAffiliated withMunich Cancer Registry (MCR, Director J. Engel) of the Munich Cancer Center (MCC) at the Institute of medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU) Munich Email author 
  • , Rebecca T. EmenyAffiliated withMunich Cancer Registry (MCR, Director J. Engel) of the Munich Cancer Center (MCC) at the Institute of medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU) Munich
  • , Jutta EngelAffiliated withMunich Cancer Registry (MCR, Director J. Engel) of the Munich Cancer Center (MCC) at the Institute of medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU) MunichTumorregister München, Klinikum Grosshadern

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Abstract

Generally, the limits of local tumor control are in part connected with the term “field cancerization” and are known from oral, lung, prostate, or mammary cancer. With the example of breast cancer (BC), the problem of ipsilateral breast tumor recurrences (IBTR) after breast-conserving surgery will be reviewed. Three types of local recurrences are distinguished: true recurrences, new primaries, or residual tumors. Good data for BC allow the description of the time-dependent risk of these three types, relative to the diagnosis of the primary tumor, because the time of initiation and the growth duration of the IBTR can be estimated. Two hypotheses explain the data: first, local recurrences may be initiated years before the diagnosis of a primary tumor (PT) and can then appear as multifocal PT at diagnosis, and second, true local recurrences probably do not metastasize. The generalizability of these hypotheses for other tumors will be discussed.

Keywords

Breast cancer Local recurrence Multifocal Multicentric tumor Metastasization process