Kinetics of mammary tumor cell growth and implications for therapy

Abstract

S underlie a discussion of the kinetics of mammary tumor cell growth.They are:1.After the best modern surgery for cancer of the breast, what fraction of all patients still bears clonogenic tumor cells which will lead to recurrence of clinical disease and death? 2. Of those patients who bear some clonogenic tumor cells immediately after surgery, what fraction are bearing 1, <lo1, <102.<lO3, <:lO4, 4 0 5 , ~1 0 6 , <lo?, 4 0 8 , <lOD, or <:lO1o-ouer and above the number which might be inactivated permanently by hostimmune reactions?3. On the average, what number of widely disseminated cancer of the breast cells left after surgery can be rendered nonclonogenic by the best regimens of the most eflective chemotherapy nuailable today (eg., 102 or lo4 or 100 or 108, etc.)?4. Is present day staging of cancer of the breast (based on nodal involvement, size of the primary, and other criteria) good enough to distinguish patient populations with a 75%, 50%, 25%, or less chance for 5-year or I0-year survival?I presume that reasonably good answers can be given to questions 1 and 4, but that quantitative data on questions 2 and 3 are not available.If we had good data on questions 2 and 3, there would be no place for speculation on the potential, or lack of potential, of optimal chemotherapy after surgery in treatment of disseminated cancer of the breast.Faced with the situation outlined above,