The possible role of stromal cell stimulation in worsening the prognosis of a subset of patients with breast cancer |
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Authors: | T H M Stewart S -C J Tsai |
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Institution: | (1) Department of Medicine, The Ottawa General Hospital, Ottawa, Ontario, Canada;(2) Breast Cancer Program, Michigan Cancer Foundation, Detroit, MI, USA;(3) The Ottawa General Hospital, Department of Medicine, Rm LM-15, 501 Smyth Road, KlH 81-6 Ottawa, Ontario, Canada |
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Abstract: | This review examines the evidence that a subset of patients with breast cancer have tumors that are stimulated to grow by host cells in the tumor stroma. The search for such a minority group was prompted by the following observations. Adjuvant chemotherapy which is immunosuppressive improves disease-free interval and survival, whereas non-specific immunostimulation worsens the prognosis. Intrinsic immune reactivity is associated with a poor prognosis. A subset of tumors with a bad prognosis has anaplastic cells, dermal lymphatic invasion and a moderate to intense lymphoplasmacytic stromal infiltrate. Evidence is reviewed that adjuvant chemotherapy may be beneficial by virtue of its immunosuppressive effects in addition to tumor kill of minimal residual disease. |
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Keywords: | breast cancer dormancy growth stimulation host stromal cells immunosuppression |
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