The theory, of the sick breast lobe and the possible consequences
The theory, of the sick breast lobe and the possible consequences
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DOI：
10.1177/1066896907302225
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发表时间：
2007-10-01
影响因子：
1.2
通讯作者：
Tot, Tibor
中科院分区：
文献类型：
--
作者：
Tot, Tibor
我们假设原位癌和一般的乳腺癌是一种肺叶疾病，因为同时或不同时出现的，通常是多个肿瘤病灶在一个肺叶内发展。患病的肺叶从胚胎早期开始就带有某种遗传不稳定性，并且比同一乳房内的其他肺叶对有害影响更敏感。患病肺叶内细胞的恶性转化需要数十年的出生后生活以及额外遗传改变的积累。这种转化通常是多灶性的（累及小叶的远端小叶）或弥漫性的（累及较大的导管）。这一假说为癌症预防提供了新的视角，因为在恶性病变发展之前选择性地观察、切除或破坏病叶将大大降低乳腺癌的发病率。
We hypothesize that carcinoma in situ, and consequently breast carcinoma in general, is a lobar disease because the simultaneously or asynchronously appearing, often multiple tumor foci develop within a single lobe. The sick lobe carries some kind of genetic instability already from its initialization during the early embryonic life and is more sensitive to noxious influences than the other lobes within the same breast. Decades of postnatal life with accumulation of additional genetic alterations are needed for malignant transformation of the cells within the sick lobe. The transformation is often multifocal (involving separate distant lobules of this lobe) or diffuse (involving the larger ducts). This hypothesis offers new perspectives in cancer prevention, because selective visualization, excision, or destruction of the sick lobe before development of malignant lesions would substantially reduce the incidence of breast carcinoma.