Importance of physical trauma on time to recurrence after primary treatment of breast cancer. Can surgical or traumatic tissue trauma synchronize growth of dormant micrometastases?
The concept of tumor dormancy, where cancer cells from a primary tumor disseminate early and enter a state of dormancy, where there is little or no growth, with a potential to cause late relapses is recognized in many cancers. This includes commonly occurring cancer forms such as breast and prostate cancer. Tumor dormancy is considered one of the major unsolved questions in cancer biology. For the majority of us, cancer cells probably remains dormant through the duration of our lifetime, as demonstrated by the large numbers of microscopic cancers discovered in autopsy studies of patients dead from other causes.
Understanding the mechanisms responsible for maintaining and interrupting dormancy would be an important step towards preventing overt metastatic disease. Experimental studies have demonstrated accelerated growth of metastases after wounding, and epidemiological studies have revealed a peak in relapses after surgical procedures. As tissue trauma and wound healing involves cell growth and migration, inflammation and angiogenesis, immune system modulation and tissue remodeling, such a link makes biological sense. Breast cancer is infamous for its potential to cause late relapses, even after resection of small primary tumors, and thus a cancer form where tumor dormancy is a substantial clinical problem. In addition, breast cancer patients frequently undergo surgical procedures, both primary tumor removal, and reconstructive surgery.
In my PhD project, we set out to study the effect of tissue trauma and wound healing on escape from tumor dormancy and metastatic relapse. We study this in epidemiological data on breast cancer recurrence dynamics and patterns as well as experimental models.
Jeg underviser legestudenter ved UiB i basale kliniske ferdigheter og lege-pasient kommunikasjon.
- 2019. Distant metastasis dynamics following subsequent surgeries after primary breast cancer removal . Breast Cancer Research. 1-10.
- 2019. Are 90% of deaths from cancer caused by metastases? Cancer Medicine. 5574-5576.
- 2016. The recurrence pattern following delayed breast reconstruction after mastectomy for breast cancer suggests a systemic effect of surgery on occult dormant micrometastases. Breast Cancer Research and Treatment. 169-178.
- 2014. Differences in metastatic patterns in relation to time between primary surgery and first relapse from breast cancer suggest synchronized growth of dormant micrometastases. Breast Cancer Research and Treatment. 627-636.
- 2016. Recurrence of breast cancer in relation to delayed reconstruction.
- 2016. Hva betyr sekundær rekonstruksjon for senere tilbakefall?
- 2019. Perioperative factors and complications after delayed reconstruction in breast cancer patients in relation to oncologic outcome.
- 2018. Surgeries reveal details of metastasis development.
- 2019. The link between wound healing and escape from tumor dormancy. 50-56.
Cand Med, Linköpings Universitet, Sverige, 2009