Romano Demicheli

TL;DR: The idea that surgical cancer resection has both beneficial and adverse effects upon cancer spread and growth that result from the modulation of tumor dormancy by the resection should be considered a potentially fruitful working hypothesis.

TL;DR: This historical perspective on breast cancer tells us how and why certain therapeutic eras have reached ascendancy and then declined and why a new crisis is upon us now in that trials of early detection have resulted in unexpected disadvantages to certain subgroups and clinical data that suggests the act of surgery might accelerate the appearance of distant metastases.

TL;DR: This study provides evidence that the hypothesis of uninterrupted constant growth of locally recurring breast tumors should be rejected, as it implies a statistically significant departure from observed data.

TL;DR: It is proposed that metastatic breast cancer growth commonly includes periods of temporary dormancy at both the single cell phase and the avascular micrometastasis phase, and surgery to remove the primary tumor often terminates dormancy resulting in accelerated relapses.

TL;DR: It is suggested that surgical extirpation of primary breast cancer among other effects accelerates relapse for some premenopausal node-positive patients, and short-course cytotoxic chemotherapy after surgery has probably reached its zenith, and other strategies are needed to successfully treat more patients.