ROLE OF CYTOKINES AND GROWTH-FACTORS IN PROMOTING THE LOCAL RECURRENCE OF BREAST-CANCER

The pathogenesis of local recurrence in breast cancer is not well unde rstood. Breast-conserving surgery is particularly prone to local recur rence as it leaves behind breast tissue that may harbour occult cancer , and lends itself to enhanced intraoperative shedding of cancer cells due to narrower resection margins and transection of lymphatic channe ls. A review of clinical breast cancer studies as well as experimental research strongly suggests that these persisting cancerous cells are unlikely to develop into clinically evident disease if their environme nt remains unstimulated. However, an inordinately high local recurrenc e rate occurs at the surgical scar, and such recurrence must be trigge red by the release of growth factors and cytokines into the healing wo und. These factors can stimulate any available cancer cells which expr ess the proper growth factor receptors. Perioperative strategies to ne utralize this tumour cell-growth factor interaction should maximize lo cal control.