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Do Breast Cancer Patients Benefit from Surgery? Hypotheses, Mathematical Models and False Beliefs

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Book cover Perioperative Inflammation as Triggering Origin of Metastasis Development

Abstract

Although much is known about the molecular biology and genomics of breast cancer at the subcellular level, clinical manifestations of the disease and its diagnosis, prognosis and treatment continue to pose major challenges. This chapter is an attempt at critical review and analysis of a few principal hypotheses about the natural history of invasive breast cancer and the effects of surgery. We address a fundamental question regarding the universality of benefits of surgery and whether it should be dropped for some categories of breast cancer patients. We present a mathematical model of metastasis that allows for evaluating the post-surgery dynamics of the metastatic cascade. We show that statistical inference from the results of clinical trials may lead to false knowledge and irreproducible results. Finally, we make a case for identification of the categories of breast cancer patients that could benefit from surgery through a model-based analysis of post-surgery metastatic relapse times. The mathematical model could also serve as an in silico surrogate for clinical trials comparing various breast cancer treatments with and without surgery.

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Authors and Affiliations

  1. Department of Mathematics and Statistics, Idaho State University, 921 S. 8th Avenue, Stop 8085, Pocatello, ID, 83209-8085, USA

    Leonid Hanin

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  1. Leonid Hanin
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Correspondence to Leonid Hanin .

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Editors and Affiliations

  1. Harvard TH Chan School of Public Health, Boston, Massachusetts, USA

    Michael W. Retsky

  2. Istituto Nazionale Tumori di Milano, Fondazione IRCCS, Milan, Italy

    Romano Demicheli

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Hanin, L. (2017). Do Breast Cancer Patients Benefit from Surgery? Hypotheses, Mathematical Models and False Beliefs. In: Retsky, M., Demicheli, R. (eds) Perioperative Inflammation as Triggering Origin of Metastasis Development. Springer, Cham. https://doi.org/10.1007/978-3-319-57943-6_7

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