Excellent Free Access Article

[Hazelgreen]

Here's a link to a long 2021 article in Nature, copied from the British Journal of Cancer: rdcu.be/cnggT

Riggio, A.I., Varley, K.E. & Welm, A.L. The lingering mysteries of metastatic recurrence in breast cancer.

Br J Cancer 124, 13–26 (2021). doi.org/10.1038/s41416-020-...

Cheers, Cindy

[jersey-jazz]

Still reading----X O

[jersey-jazz]

I have re-read the article, "The lingering mysteries of metastatic recurrence in breast cancer". It wasn't an easy read!. The title speaks to our condition and explains how it all happens. There are a lot of thought provoking threads in the piece.

[jersey-jazz]

This is a continuation of the above reply. I had to leave and now I'm back. The article is difficult to read because there is so much information in it. It reads more like a textbook and is important enough to print a copy to refer to. . The main part of interest to me is the list of low cost ways of detection which includes my hobby horse; what is called, in the article, circulating tumour DNA methylation and what I have been referring to as a circulating tumor blood test.

It seems to me that here is a wonderful tool useful to many of us who already have been diagnosed with MBC but have the lucky possibility of having oligo metastisis. I've asked repeatedly for this test and actually called the manufacture of it. MSKCC is using it in only one department. So far, the oncologist is not considering using it any time soon. What a shame!.

Are there any of you who are wondering if you are oligo metastasis?

[Hazelgreen]

Hi Francis,I agree with you that this article indicates that "non-invasive biomarker assays" should be in widespread use with BC patients for the "early detection of cancer recurrence". The article also suggests to me that "liquid biopsy" detection of molecular changes in metastatic recurrence might be useful in terms of treatment decisions.

I'm less clear as to how this tool might be of particular use in "oligometastases"?? What is it that you are hoping to discover?

Here's another article you might be interested in:

Review Int J Cancer. 2021 May 20. doi: 10.1002/ijc.33693. Online ahead of print.

Oligometastatic breast cancer: Are we there yet?

Many hugs, my friend,

Cindy

[Hazelgreen]

Here is the abstract to the article I mentioned above:

Abstract

Patients with metastatic breast cancer are usually considered incurable. Recent advances have resulted in significant improvements in survival for patients with metastatic breast cancer. Due to the lack of randomised trials and heterogeneous disease biology, treatment decisions for patients with oligometastatic breast cancer vary widely. Some patients are treated similar to those with widespread disease while others are treated more aggressively. We conducted a review of the evidence for treatment options in oligometastatic breast cancer and consulted ClinicalTrials.gov to explore currently accruing or studies in development aimed at investigating oligometastatic disease in breast cancer. Surgery to the primary tumour in patients with metastatic breast cancer has failed to show any advantage over systemic therapy. However, there may be a benefit in women with controlled systemic disease who are hormone receptor positive with bone-predominant metastasis. Stereotactic radiotherapy has gained increased interest in this setting due to its excellent efficacy and lower rates of associated toxicity. A significant challenge remains in identifying the patient population who would benefit from such an approach, and to do so, we need to understand the distinct biology of oligometastatic breast cancer. Unique miRNA expression and low levels of tumour infiltrating lymphocytes in the immune micro-environment have been described in tumour tissues in patients with oligometastatic breast cancer. There is ongoing research aimed to better characterise these tumours, thus, allowing the selection of patients who would truly benefit from multi-modality treatment in an attempt for long-term survival and cure.

Cheers,

Cindy