乳腺癌是女性最常诊断出的恶性肿瘤，在全球范围内癌症相关死亡的主要原因中占有突出地位。尽管治疗方式取得了显着进步，但大约 20% 的患者在诊断后监测的前 5 年后会出现复发。虽然 20 世纪 70 年代的初步研究表明保乳手术 (BCS) 联合放射治疗和乳房切除术之间的生存率相当，但最近的研究表明，在现代全身治疗和放射治疗的背景下，先进行 BCS 再进行放射治疗可能会提高总体生存率益处。然而，长期随访研究表明，与乳房切除术相比，保乳治疗相关的局部复发风险显着增加。本文介绍了一种植根于归巢生物学现象的新假设，以阐明这一有趣的临床观察结果。我们假设由至少涉及 CXCR4-SDF-1 轴的趋化性介导的重新激活的循环和播散肿瘤细胞的乳房归巢机制可能为这种临床现象提供生物学原理。版权所有 © 2023 作者。由爱思唯尔公司出版。保留所有权利。

Breast cancer stands as the most frequently diagnosed malignancy in women, holding a prominent position among the leading causes of cancer-related fatalities on a global scale. Despite significant advances in treatment modalities, approximately 20% of patients experience relapses after the first 5 years of postdiagnosis surveillance. While initial investigations from the 1970s indicated comparable survival rates between breast-conserving surgery (BCS) coupled with radiation therapy and mastectomy, recent research suggests that, within the context of modern systemic and radiation therapy, BCS followed by radiation may offer an improved overall survival benefit. Nevertheless, extended follow-up studies have unveiled a notable increase in the risk of locoregional recurrence associated with breast conserving therapy in contrast to mastectomy. This article introduces a novel hypothesis rooted in the biological phenomenon of homing to elucidate this intriguing clinical observation. We postulate that a breast homing mechanism of reactivated circulating and disseminated tumor cells mediated by chemotaxis involving at least the CXCR4-SDF-1 axis may provide a biological rationale for this clinical phenomenon.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.